Healthcare Provider Details

I. General information

NPI: 1316866320
Provider Name (Legal Business Name): KATYA KENNEDY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9350 INDEPENDENCE DR STE 201
ANCHORAGE AK
99507-4619
US

IV. Provider business mailing address

PO BOX 220644
ANCHORAGE AK
99522-0644
US

V. Phone/Fax

Practice location:
  • Phone: 951-999-1874
  • Fax:
Mailing address:
  • Phone: 951-999-1874
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: EKATERINA KENNEDY
Title or Position: OWNER
Credential:
Phone: 951-999-1874