Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Mary Henretig

Individual provider Mental Health Counselor · NPI 1316372139

Jacqueline Mary Henretig is a Clinical Psychologist in Tempe, Arizona. Qualified in 2016, 10 years ago. Licensed in Arizona.

Years since qualifying
10
Licensed in
AZ
In the registry since
2013
Specialties on file
2
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Practice location Address checks out

1840 E Broadway Rd
Tempe, AZ 85282-1614
Phone: (022) 437-2776
Fax: (480) 927-1092
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PSY-005432 (AZ)
Mental Health Counselor Taxonomy 101YM0800X

Record details

NPI number1316372139
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 11, 2013
Last updated in NPPESAugust 5, 2021
Certification dateAugust 5, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated

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