Healthcare Provider Details
I. General information
NPI: 1225129828
Provider Name (Legal Business Name): LUCAS ALLEN ROWLEY LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 08/05/2024
Certification Date: 08/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4320 DIPLOMACY DR STE 1500
ANCHORAGE AK
99508-5925
US
IV. Provider business mailing address
7033 E TUDOR RD
ANCHORAGE AK
99507-1262
US
V. Phone/Fax
- Phone: 907-729-2500
- Fax:
- Phone: 907-729-8901
- Fax: 907-729-5180
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | PCOP621 |
| License Number State | AK |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | PCOP621 |
| License Number State | AK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: