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NPI Code Detail

MEDICARE: JACLYN SUTTON RANGEL LPC

MEDICARE: JACLYN SUTTON RANGEL LPC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorCP5798NV
2101YA0400XAddiction (Substance Use Disorder) Counselor00687-CNV
3101YM0800XMental Health CounselorCP5798NV
4101YP2500XProfessional CounselorCP5798NV
5101YP2500XProfessional Counselor234271AK

General Provider Information

NPI Number : 1831535095
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACLYN SUTTON RANGEL LPC
Provider Business Mailing Address
First Line : 3600 SAN JERONIMO DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2870
Country : US
Telephone Number : 907-793-3600
Fax Number :
Provider Business Practice Location Address
First Line : 3149 MOUNTAIN VIEW DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3106
Country : US
Telephone Number : 907-793-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2013
Last Update Date : 06/25/2025

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Directions to “ JACLYN SUTTON RANGEL LPC” Practice Location

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