Provider Demographics
NPI:1942954821
Name:ELLIOT, KADE M (LPC)
Entity type:Individual
Prefix:
First Name:KADE
Middle Name:M
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KADE
Other - Middle Name:M
Other - Last Name:ELLIOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:255 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3303
Mailing Address - Country:US
Mailing Address - Phone:610-890-9856
Mailing Address - Fax:
Practice Address - Street 1:255 S 16TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3303
Practice Address - Country:US
Practice Address - Phone:610-890-9856
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC019107101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health