Healthcare Provider Details

I. General information

NPI: 1083329288
Provider Name (Legal Business Name): FLEXIBLE COUNSELING SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2023
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1075 S CHECK ST STE 110
WASILLA AK
99654-8067
US

IV. Provider business mailing address

1075 S CHECK ST STE 110
WASILLA AK
99654-8067
US

V. Phone/Fax

Practice location:
  • Phone: 907-376-3539
  • Fax:
Mailing address:
  • Phone: 907-376-3539
  • Fax: 907-215-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1735601
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer

VIII. Authorized Official

Name: BRIDGETTE EVANS
Title or Position: SOLE MEMBER
Credential: MSW, LCSW
Phone: 907-376-3539