Provider Demographics
NPI:1326894866
Name:WELLS, KIERSTEN (LCSW)
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:
Last Name:WELLS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 N CENTRAL AVE STE 1050
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1217
Mailing Address - Country:US
Mailing Address - Phone:602-266-8402
Mailing Address - Fax:602-264-0887
Practice Address - Street 1:9051 W KELTON LN STE 13
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-3533
Practice Address - Country:US
Practice Address - Phone:623-815-5700
Practice Address - Fax:623-815-5759
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-221821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical