Individual provider Active NPI

Kristen Liptow, LAC

  • Mental Health Counselor
  • Phoenix, AZ
National Provider Identifier
1306679204
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LAC-23034 Issued in AZ
Practice address
34975 N North Valley Pkwy Ste 152
Phoenix, AZ 85086-4032
Phone
(480) 309-7300
NPI assigned
Aug 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LAC-23034 AZ Primary

Addresses

Primary practice location

34975 N North Valley Pkwy Ste 152
Phoenix, AZ 85086-4032

Mailing address

4521 W Shaw Butte Dr
Glendale, AZ 85304-3036
Phone (480) 309-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LAC-23034AZMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1306679204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 W SHAW BUTTE DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853043036",
            "telephone_number": "480-309-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34975 N NORTH VALLEY PKWY STE 152",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850864032",
            "telephone_number": "480-309-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPTOW",
        "first_name": "KRISTEN",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-23034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.