Healthcare Provider Details

I. General information

NPI: 1932197167
Provider Name (Legal Business Name): CRISTINA ANN ACKERMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA ANN SCHNEIDER NONE

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 05/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 PEGER RD SUITE 200
FAIRBANKS AK
99709-5453
US

IV. Provider business mailing address

3180 PEGER RD SUITE 200
FAIRBANKS AK
99709-5453
US

V. Phone/Fax

Practice location:
  • Phone: 907-451-0300
  • Fax: 907-451-0306
Mailing address:
  • Phone: 907-451-0300
  • Fax: 907-451-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number594
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number738
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: