| Fairbanks Community Mental Health Services, Llc | |
|
3830 S Cushman St Fairbanks AK 99701-7530 | |
| (907) 371-1300 | |
| (907) 770-8917 |
| Full Name | Fairbanks Community Mental Health Services, Llc |
|---|---|
| Speciality | Psychologist - Prescribing (medical) |
| Location | 3830 S Cushman St, Fairbanks, Alaska |
| Authorized Official Name and Position | Amy Morrow (BILLING MANAGER) |
| Authorized Official Contact | 9077622820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairbanks Community Mental Health Services, Llc 4020 Folker St Anchorage AK 99508-5321 Ph: (907) 561-1000 | Fairbanks Community Mental Health Services, Llc 3830 S Cushman St Fairbanks AK 99701-7530 Ph: (907) 371-1300 |
| NPI Number | 1972987998 |
|---|---|
| Provider Enumeration Date | 07/20/2015 |
| Last Update Date | 07/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972987998 | NPI | - | NPPES |
| K165350 | Other | AK | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
| 103TR0400X | Psychologist - Rehabilitation | (* (Not Available)) | Secondary |
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