Healthcare Provider Details

I. General information

NPI: 1700330875
Provider Name (Legal Business Name): MARIKA VADEN HANSON LPC, CSSP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARIKA VADEN LPC, CSSP

II. Dates (important events)

Enumeration Date: 08/06/2016
Last Update Date: 12/27/2025
Certification Date: 12/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SALMON CREEK LN STE 2
JUNEAU AK
99801-7867
US

IV. Provider business mailing address

PO BOX 240446
DOUGLAS AK
99824-0446
US

V. Phone/Fax

Practice location:
  • Phone: 907-738-5747
  • Fax:
Mailing address:
  • Phone: 907-738-5747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberCSSP-14
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2461274
License Number StateID
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number228884
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC-2292
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: