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General NPI Number Information
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NPI Number | 1770098311
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Entity Type | Individual
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Provider Name | KIMBERLY A ELLIOTT LPCC
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Gender | Female
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 01/05/2026
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Provider Practice Location Address
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Address Line | 8332 W THUNDERBIRD RD
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City | PEORIA
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State | AZ
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Zip | 85381-4822
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Country | US
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Telephone | 928-707-9030
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Fax |
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Provider Business Mailing Address
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Address Line | 8332 W THUNDERBIRD RD
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City | PEORIA
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State | AZ
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Zip | 85381-4822
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19698
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | C.100336
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CTB-2023-0220
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0017742
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License Number State | CO
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