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

Kaylee Rae Licciardi, LAC

Individual provider Professional Counselor · NPI 1255196333

Kaylee Rae Licciardi, LAC is a Mental Health Counselor in Tempe, Arizona. Qualified in 2023, 3 years ago. Licensed in Arizona.

Years since qualifying
3
Licensed in
AZ
In the registry since
2024
What do these letters mean?
LAC — Licensed Associate Counselor
A counsellor practising under supervision toward full licensure. In some states the same letters mean Licensed Acupuncturist.

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Practice location Address checks out

2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692
Phone: (480) 804-0326
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC-24925 (AZ)

Record details

NPI number1255196333
Entity typeIndividual (Type 1)
GenderFemale
Credentials LAC
Sole proprietorNo
NPI enumeratedFebruary 16, 2024
Last updated in NPPESJune 18, 2026
Certification dateJune 18, 2026

Medicare enrollment

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

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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