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 and is a graduate of Other (2023).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kaylee Rae Licciardi Lac is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Kaylee Licciardi reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tempe, AZ 85282
- Reassigned Medicare billing, Arizona enrollment
- 57 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
Which organization bills Medicare for Kaylee Licciardi's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kaylee Licciardi reassigns Medicare benefits to Crisis Preparation And Recovery, Inc (Tempe, AZ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kaylee Licciardi's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kaylee Licciardi accept?
Health plans from Blue Cross Blue Shield of Arizona and Oscar Health Plan, Inc. list Kaylee Licciardi as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
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 4 months 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
- **Bills Medicare through:** Crisis Preparation And Recovery, Inc (NPI 1912270422, Tempe, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2023
## Record status
- **NPPES last updated:** June 18, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1255196333) · Data from the CMS NPPES public registry.