Healthcare Provider Details

I. General information

NPI: 1154112167
Provider Name (Legal Business Name): LINDSEY TIPTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 N BINKLEY ST STE 202
SOLDOTNA AK
99669-7500
US

IV. Provider business mailing address

245 N BINKLEY ST STE 202
SOLDOTNA AK
99669-7500
US

V. Phone/Fax

Practice location:
  • Phone: 907-714-4521
  • Fax:
Mailing address:
  • Phone: 907-714-4521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: