MRS. RAE ANN HENDRICKSON (NPI# 1285872317) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285872317 |
| Entity Type | Individual |
| Full Name | MRS. RAE ANN HENDRICKSON |
| Credential | LPC |
| Practice Address |
5730 E Pilgrim Ct Suite A Wasilla AK 99654-7824 |
| Practice Telephone | 9073576513 |
| Practice Fax Number | 9073576514 |
| Mailing Telephone | 9073576513 |
| Mailing Fax Number | 9073576514 |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2015-12-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
2373 | AK | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
558 | AK | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
558 | AK | Behavioral Health & Social Service Providers |
| Street Address |
5730 E PILGRIM CT SUITE A |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689092991 | Kimberly Stephens | Counselor | 5730 E Pilgrim Ct, Suite B, Wasilla, AK 99654-7824 | 2014-04-03 |
| 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 |
| 1093212466 | Lighted Path Therapy Services | Counselor | 901 N. Leatherleaf Loop Suite 103, Wasilla, AK 99654 | 2018-04-11 |
| 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 |
| 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.