Healthcare Provider Details

I. General information

NPI: 1346919404
Provider Name (Legal Business Name): CHRISTIAN COUNSELING ONLINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10007 LEE ST
EAGLE RIVER AK
99577-8354
US

IV. Provider business mailing address

10007 LEE ST
EAGLE RIVER AK
99577-8354
US

V. Phone/Fax

Practice location:
  • Phone: 907-444-6693
  • Fax: 417-374-0271
Mailing address:
  • Phone: 907-444-6693
  • Fax: 417-374-0271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER SUSAN SKAVHAUG
Title or Position: OWNER/OPERATOR
Credential: LPC
Phone: 907-444-6693