Individual provider Active NPI

Kimberly Van Wuffen, LPC

  • Professional Counselor
  • Phoenix, AZ
National Provider Identifier
1114673837
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-20531 Issued in AZ
Practice address
4435 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7651
Phone
(833) 351-8255
NPI assigned
Feb 22, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC-20531 AZ Primary

Addresses

Primary practice location

4435 E Chandler Blvd Ste 200
Phoenix, AZ 85048-7651

Mailing address

109 W 27TH St RM 5S
New York, NY 10001-6208
Phone (833) 351-8255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250514002371 AZ Practitioner - Mental Health Counselor 7012435985 Reassigns benefits to 1 organization
I20251106003221 TX Practitioner - Mental Health Counselor 7012435985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

13555 E Soleil Down Rd
Mayer, AZ 86333-2333

17503 La Cantera Pkwy
Suite 104
San Antonio, TX 78257-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC-20531AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alaniz Counseling and Behavioral Center, P.C. Professional CurrentSince Oct 6, 2025 Accepting new patients
Vcounselors PLLC Professional CurrentSince Oct 6, 2025 Accepting new patients
MCCD FL Psychiatry Services PA CurrentSince Apr 7, 2025 Accepting new patients

Locations

4435 E Chandler Blvd
Ste 200
Phoenix, AZ 85048
Phone (480) 930-2322

109 W 27th St
Rm 5S
New York, NY 10001
Phone (332) 230-4572

5522 Lone Star Pkwy
Ste 303
San Antonio, TX 78253
Phone (210) 614-4990

17503 La Cantera Pkwy
Ste 104
San Antonio, TX 78257
Phone (210) 564-9116

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1114673837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 W 27TH ST RM 5S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100016208",
            "telephone_number": "833-351-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 E CHANDLER BLVD STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850487651",
            "telephone_number": "833-351-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WUFFEN",
        "first_name": "KIMBERLY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-22",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-20531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.