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SHARON ANN LAKE LPC
>> Specialist >> Other Service ProvidersRegistrant NPI Number: 1326193079
Individual Registrant: SHARON ANN LAKE LPC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
2509 EIDE ST. ANCHORAGE, AK 99503 US
Tel: 907-244-8872 Fax: 907-563-3217
Tel: 907-244-8872 Fax: 907-563-3217
Contact information for business:
8230 KIP CT. ANCHORAGE, AK 99507-3245 US
Tel: 907-244-8872 Fax: 907-563-3217
Tel: 907-244-8872 Fax: 907-563-3217
Registration Information:
NPI: 1326193079
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 174400000X | Other Service Providers Specialist | ||
| Y | 101YP2500X | Behavioral Health & Social Service Providers Counselor | AK | 614 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| PENDING | AK | 05 |
