LIGHTED PATH THERAPY SERVICES (NPI# 1093212466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093212466 |
| Entity Type | Organization |
| Organization Name | LIGHTED PATH THERAPY SERVICES |
| Practice Address |
901 N. Leatherleaf Loop Suite 103 Wasilla AK 99654 |
| Mailing Address |
Po Box 871336 Wasilla AK 99654 |
| Practice Telephone | 9073121202 |
| Practice Fax Number | 8555538083 |
| Mailing Telephone | 9073121202 |
| Mailing Fax Number | 8555538083 |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |
| Authorized Official Name | BRADFORD ERIC HOLL (OWNER) |
| Authorized Official Telephone | 9073121202 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
809 | AK | Behavioral Health & Social Service Providers |
| Street Address |
901 N. LEATHERLEAF LOOP SUITE 103 |
| City | WASILLA |
| State | AK |
| Zip Code | 99654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437778602 | Kirklin Kinney | Counselor | 5801 E Bogard Rd, Wasilla, AK 99654-4267 | 2020-04-08 |
| 1598250672 | Kristen Allton | Counselor | 4315 E Echo Ave, Wasilla, AK 99654-4436 | 2018-06-29 |
| 1548787534 | Vicki Lee Bowker | Counselor | 645 N Jessica Brooke Cir Ste F2, Wasilla, AK 99654-7333 | 2017-08-29 |
| 1932648680 | Bonni Harter | Counselor | 491 N. Knik Street, Wasilla, AK 99654 | 2017-02-14 |
| 1437524204 | Deborah Bannan | Counselor | 5730 E Pilgrim Ct Ste A, Wasilla, AK 99654-7824 | 2015-12-04 |
| 1316382070 | Leah Allen | Counselor | 865 N Seward Meridian Pkwy Ste 104, Wasilla, AK 99654-7241 | 2013-05-07 |
| 1578853859 | Community Counseling & Consulting, LLC | Counselor | 300 W Graybark Dr, Unit B, Wasilla, AK 99654-6382 | 2011-04-07 |
| 1417264805 | Dara Harrel | Counselor | 500 N Main St Ste E, Wasilla, AK 99654 | 2010-09-07 |
| 1609191188 | David Sage | Counselor | 3060 N Lazy Eight Ct Suite 2 108, Wasilla, AK 99654 | 2010-03-29 |
| 1427383181 | Richard Clampitt | Counselor | 601 N Bunker Hill St, Wasilla, AK 99654-6790 | 2009-10-13 |
| Find all providers in WASILLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.