Healthcare Provider Details

I. General information

NPI: 1790025872
Provider Name (Legal Business Name): DESSIE PIERCE MA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2013
Last Update Date: 03/09/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 GREG KRUSCHEK
NOME AK
99762-0966
US

IV. Provider business mailing address

PO BOX 966
NOME AK
99762-0966
US

V. Phone/Fax

Practice location:
  • Phone: 907-443-3344
  • Fax:
Mailing address:
  • Phone: 907-443-3344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number70404
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number157410
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: