Provider Demographics
NPI:1831317270
Name:KHALSA, ADI SHAKTI KAUR (LPC)
Entity type:Individual
Prefix:
First Name:ADI SHAKTI
Middle Name:KAUR
Last Name:KHALSA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2122 E HIGHLAND AVE STE 420
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4739
Mailing Address - Country:US
Mailing Address - Phone:480-820-5186
Mailing Address - Fax:
Practice Address - Street 1:2122 E HIGHLAND AVE STE 420
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4739
Practice Address - Country:US
Practice Address - Phone:480-820-5186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23295101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool