Healthcare Provider Details

I. General information

NPI: 1649422189
Provider Name (Legal Business Name): KRISTIE A ALLEVA MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2008
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

491 N KNIK ST
WASILLA AK
99654-7049
US

IV. Provider business mailing address

491 N KNIK ST
WASILLA AK
99654-7049
US

V. Phone/Fax

Practice location:
  • Phone: 907-376-9500
  • Fax:
Mailing address:
  • Phone: 907-376-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number927
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: