Healthcare Provider Details

I. General information

NPI: 1659031003
Provider Name (Legal Business Name): HOPEFUL PATH COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5921 W DEWBERRY DR
WASILLA AK
99623-1934
US

IV. Provider business mailing address

7362 W PARKS HWY # 523
WASILLA AK
99623-9300
US

V. Phone/Fax

Practice location:
  • Phone: 907-600-1106
  • Fax: 907-600-1107
Mailing address:
  • Phone: 907-600-1106
  • Fax: 907-600-1107

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:

VIII. Authorized Official

Name: SARAH BLANNING
Title or Position: OWNER
Credential: LCSW
Phone: 907-600-1106