Healthcare Provider Details

I. General information

NPI: 1558161778
Provider Name (Legal Business Name): ALASKA OGDEN M.A., LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7756 NORTHCROSS DR STE 203
AUSTIN TX
78757-1725
US

IV. Provider business mailing address

1213 HOLLOW CREEK DR APT 1
AUSTIN TX
78704-1996
US

V. Phone/Fax

Practice location:
  • Phone: 512-663-1398
  • Fax:
Mailing address:
  • Phone: 512-663-1398
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number98145
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: