Healthcare Provider Details

I. General information

NPI: 1538289335
Provider Name (Legal Business Name): YVONNE M CHASE ACSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 C ST SUITE 117
ANCHORAGE AK
99501-5115
US

IV. Provider business mailing address

1675 C ST SUITE 117
ANCHORAGE AK
99501-5115
US

V. Phone/Fax

Practice location:
  • Phone: 907-274-8281
  • Fax: 907-274-4055
Mailing address:
  • Phone: 907-274-8281
  • Fax: 907-274-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number125
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: