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NPI Code Detail

MEDICARE: KIMBERLY A ELLIOTT LPCC

MEDICARE: KIMBERLY A ELLIOTT LPCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor19698AZ
2101YM0800XMental Health CounselorC.100336OH
3101YM0800XMental Health CounselorCTB-2023-0220NM
4101YM0800XMental Health Counselor0017742CO

General Provider Information

NPI Number : 1770098311
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY A ELLIOTT LPCC
Provider Business Mailing Address
First Line : 8332 W THUNDERBIRD RD
Second Line :
City : PEORIA
State : AZ
Zip : 85381-4822
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8332 W THUNDERBIRD RD
Second Line :
City : PEORIA
State : AZ
Zip : 85381-4822
Country : US
Telephone Number : 928-707-9030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2017
Last Update Date : 01/05/2026

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Directions to “ KIMBERLY A ELLIOTT LPCC” Practice Location

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