Healthcare Provider Details

I. General information

NPI: 1831448471
Provider Name (Legal Business Name): CICELY ELIZABETH KAUL M.A., LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

IV. Provider business mailing address

10201 MISSION GORGE RD STE O
SANTEE CA
92071-3040
US

V. Phone/Fax

Practice location:
  • Phone: 619-383-6868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPCC5460
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4006
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: