Healthcare Provider Details

I. General information

NPI: 1578660825
Provider Name (Legal Business Name): KIMBERLY ANNE POPKEY MA, LPC, CEDS, SEP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/06/2022
Certification Date: 08/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8160 E BUTHERUS DR STE 5
SCOTTSDALE AZ
85260-2523
US

IV. Provider business mailing address

8160 E BUTHERUS DR STE 5
SCOTTSDALE AZ
85260-2523
US

V. Phone/Fax

Practice location:
  • Phone: 480-390-1409
  • Fax: 480-383-6825
Mailing address:
  • Phone: 480-390-1409
  • Fax: 480-383-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-2248
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-2248
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: