Healthcare Provider Details

I. General information

NPI: 1629586656
Provider Name (Legal Business Name): SHAWNDEAN HUTCHISON LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2018
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3875 GEIST RD PMB E #431
FAIRBANKS AK
99709-3501
US

IV. Provider business mailing address

3875 GEIST RD PMB E #431
FAIRBANKS AK
99709-3501
US

V. Phone/Fax

Practice location:
  • Phone: 907-671-0160
  • Fax: 833-789-0336
Mailing address:
  • Phone: 907-671-0160
  • Fax: 833-789-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number128458
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: