Healthcare Provider Details

I. General information

NPI: 1649960774
Provider Name (Legal Business Name): ALYSSA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4045 LAKE OTIS PKWY
ANCHORAGE AK
99508-5227
US

IV. Provider business mailing address

4020 FOLKER ST
ANCHORAGE AK
99508-5386
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-1000
  • Fax:
Mailing address:
  • Phone: 907-563-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: