Provider Demographics
NPI:1770130320
Name:CZAPLEWSKI, JOHN MARK (PSY D)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:MARK
Last Name:CZAPLEWSKI
Suffix:
Gender:M
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10215 E CATALYST AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-8105
Mailing Address - Country:US
Mailing Address - Phone:402-957-6371
Mailing Address - Fax:
Practice Address - Street 1:7776 S POINTE PKWY W STE 250
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5428
Practice Address - Country:US
Practice Address - Phone:480-382-7761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103G00000X
AZ005602103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist