Kaylee Rae Licciardi, LAC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC-24925 Issued in AZ

Practice address

2120 S McClintock Dr Ste 105
Tempe, AZ 85282-2692

Phone

(480) 804-0326

NPI assigned

Feb 16, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kaylee Gross Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781740800000",
    "number": "1255196333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-804-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 S MCCLINTOCK DR STE 105",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852822692",
            "telephone_number": "480-804-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICCIARDI",
        "first_name": "KAYLEE",
        "middle_name": "RAE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-16",
        "last_updated": "2026-06-18",
        "certification_date": "2026-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-24925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAYLEE",
            "last_name": "GROSS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Rae Lewis, COTA/L
• Tamara Diane Lewis
• Alejandra Leyva
• Tong Li, MD
• Nikki Lynn Libby, LPC
• Taylor Lickteig
• Kathy Lieberman
• Kari Marie Lien
• Alyson Elaine Liew-Spilger, DO
• Life N Love Wellness Inc

• Professional Counselor in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.