Provider Demographics
NPI:1831513753
Name:NEUDORFF, KATIE LEIGH (LPC, LMHC)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:LEIGH
Last Name:NEUDORFF
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8621 N 48TH LN
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85302-5102
Mailing Address - Country:US
Mailing Address - Phone:425-870-1583
Mailing Address - Fax:360-363-4235
Practice Address - Street 1:8621 N 48TH LN
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85302-5102
Practice Address - Country:US
Practice Address - Phone:425-870-1583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-12
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61048273101YM0800X
AZLPC-23046101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health