Healthcare Provider Details

I. General information

NPI: 1508776097
Provider Name (Legal Business Name): ASHLEY BROOKS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

700 CHIEF EDDIE HOFFMAN HWY
BETHEL AK
99559-4103
US

IV. Provider business mailing address

PO BOX 2946
BETHEL AK
99559-2946
US

V. Phone/Fax

Practice location:
  • Phone: 907-543-6000
  • Fax:
Mailing address:
  • Phone: 907-545-4475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number252213
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: