MEDICARE: COUNSELING SOLUTIONS OF ALASKA LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	2084P0800X	Psychiatry Physician
2	106H00000X	Marriage & Family Therapist
3	103TC0700X	Clinical Psychologist
4	1041C0700X	Clinical Social Worker
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	AK

General Provider Information

NPI Number	:	1477682623
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING SOLUTIONS OF ALASKA LLC

Provider Business Mailing Address
First Line	:	PO BOX 240068
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99524-0068
Country	:	US
Telephone Number	:	907-644-8044
Fax Number	:	907-644-8004

Provider Business Practice Location Address
First Line	:	701 E TUDOR RD
Second Line	:	SUITE 135
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-7409
Country	:	US
Telephone Number	:	907-644-8044
Fax Number	:	907-644-8004

Authorized Official
Title or Position	:	PARTNER
Name	:	MS. KATHLEEN A GIANOTTI
Credential	:	LMFT LPC
Telephone Number	:	907-644-8044

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	03/25/2009

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