Healthcare Provider Details

I. General information

NPI: 1851854798
Provider Name (Legal Business Name): SIENA COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

174 SPRUCE ST
ANDERSON AK
99744
US

IV. Provider business mailing address

PO BOX 80355
FAIRBANKS AK
99708-0355
US

V. Phone/Fax

Practice location:
  • Phone: 907-251-7664
  • Fax:
Mailing address:
  • Phone: 907-251-7664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MARIEL MITCHELL OTT GEBHARDT
Title or Position: OWNER
Credential: LCSW
Phone: 907-251-7664