Healthcare Provider Details

I. General information

NPI: 1316859705
Provider Name (Legal Business Name): LONE WOLF COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5272 CAPE SEVILLE DR
ANCHORAGE AK
99516-7525
US

IV. Provider business mailing address

5272 CAPE SEVILLE DR
ANCHORAGE AK
99516-7525
US

V. Phone/Fax

Practice location:
  • Phone: 907-717-3713
  • Fax:
Mailing address:
  • Phone: 907-531-2560
  • Fax: 907-531-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: BRUCE AARON LINQUIST
Title or Position: SOCIAL WORKER
Credential: LCSW, CADAC, CS
Phone: 907-717-3713