MEDICARE: CAROL E SOUZA

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1881481166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL E SOUZA

Provider Business Mailing Address
First Line	:	15720 SOUTHPARK LOOP
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99516-4849
Country	:	US
Telephone Number	:	907-301-6337
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 SPENARD RD STE 200
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-1644
Country	:	US
Telephone Number	:	855-573-4980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2025
Last Update Date	:	04/22/2025

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Directions to “ CAROL E SOUZA ” Practice Location

Language	Start Address	Practice Location

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