Healthcare Provider Details

I. General information

NPI: 1730370677
Provider Name (Legal Business Name): SHELLY KARG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2007
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4076 NEELY RD
FORT WAINWRIGHT AK
99703
US

IV. Provider business mailing address

4076 NEELY RD
FORT WAINWRIGHT AK
99703
US

V. Phone/Fax

Practice location:
  • Phone: 907-361-6299
  • Fax:
Mailing address:
  • Phone: 907-361-6299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCSWS933
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: