KAYLEE RAE LICCIARDI LAC
NPI 1255196333
Counselor - Professional in Tempe, AZ
About Kaylee Rae Licciardi Lac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KAYLEE RAE LICCIARDI LAC (NPI 1255196333) is an individual professional provider in Tempe, Arizona, licensed in Arizona (LPC-24925) and active in the NPI registry since February 2024. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kaylee Rae Licciardi Lac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TEMPE, AZ 85282
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kaylee Licciardi's NPI number?
The NPI number for Kaylee Licciardi is 1255196333. It was assigned to this individual provider in the NPPES registry on February 16, 2024. The provider is also known as Kaylee Gross.
Where is Kaylee Licciardi located?
Kaylee Licciardi practices at 2120 S Mcclintock Dr Ste 105, Tempe, AZ 85282. The listed phone number is (480) 804-0326.
What is Kaylee Licciardi's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Kaylee Licciardi enrolled in Medicare?
Yes. Kaylee Licciardi is registered in the Medicare PECOS enrollment system.
When was this NPI record last updated?
The NPPES record for Kaylee Licciardi was last updated on June 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 55 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kaylee Rae Licciardi, LAC · NPI 1255196333
Professional provider in Tempe, Arizona. Individual provider, active in the CMS NPPES registry since February 16, 2024.
## Identity
- **NPI:** 1255196333 (Entity type: Individual)
- **Enumerated:** February 16, 2024
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC-24925 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 2120 S MCCLINTOCK DR STE 105, Tempe, AZ 85282-2692
- **Phone:** (480) 804-0326
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
## Record status
- **NPPES last updated:** June 18, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1255196333) · Data from the CMS NPPES public registry.