| Headwaters Wellness And Counseling Llc | |
|
250 Cushman St Suite 4j Fairbanks AK 99701-4665 | |
| (907) 456-2256 | |
| (907) 456-2260 |
| Full Name | Headwaters Wellness And Counseling Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 250 Cushman St, Fairbanks, Alaska |
| Authorized Official Name and Position | Liz Pawelko (OWNER) |
| Authorized Official Contact | 9074562256 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Headwaters Wellness And Counseling Llc 250 Cushman St Ste 5 Fairbanks AK 99701-4665 Ph: (907) 456-2256 | Headwaters Wellness And Counseling Llc 250 Cushman St Suite 4j Fairbanks AK 99701-4665 Ph: (907) 456-2256 |
| NPI Number | 1962945709 |
|---|---|
| Provider Enumeration Date | 11/28/2016 |
| Last Update Date | 12/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962945709 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | PCOC613 (Alaska) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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