Healthcare Provider Details

I. General information

NPI: 1912781428
Provider Name (Legal Business Name): SARAH H LEAVITT, LPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 LINCOLN ST STE 234
SITKA AK
99835-7676
US

IV. Provider business mailing address

4050 LAKE OTIS PKWY STE 105
ANCHORAGE AK
99508-5220
US

V. Phone/Fax

Practice location:
  • Phone: 907-227-8001
  • Fax:
Mailing address:
  • Phone: 907-227-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: SARAH H LEAVITT
Title or Position: OWNER
Credential:
Phone: 907-227-8001