Healthcare Provider Details

I. General information

NPI: 1366008252
Provider Name (Legal Business Name): JUSTIN DOGGETT LPC/S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4341 TUDOR CENTRE DR STE 353
ANCHORAGE AK
99508-5904
US

IV. Provider business mailing address

7033 E TUDOR RD
ANCHORAGE AK
99507-1262
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-7226
  • Fax:
Mailing address:
  • Phone: 907-729-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number123540
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number206985
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: