| Alaska Counselor Lpc | |
|
1200 Tongass Ave Ketchikan AK 99901-6136 | |
| (907) 220-6090 | |
| Not Available |
| Full Name | Alaska Counselor Lpc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1200 Tongass Ave, Ketchikan, Alaska |
| Authorized Official Name and Position | Ruth Bullock (OWNER) |
| Authorized Official Contact | 9072206090 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alaska Counselor Lpc 410 Tower Rd Ketchikan AK 99901-5357 Ph: (907) 220-6090 | Alaska Counselor Lpc 1200 Tongass Ave Ketchikan AK 99901-6136 Ph: (907) 220-6090 |
| NPI Number | 1164163259 |
|---|---|
| Provider Enumeration Date | 04/05/2022 |
| Last Update Date | 04/05/2022 |
| Certification Date | 04/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164163259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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