=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023977998
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TAILWIND COUNSELING AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2026
-----------------------------------------------------
Last Update Date | 01/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1075 S CHECK ST STE 101
-----------------------------------------------------
City | WASILLA
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99654-8067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-214-2808
-----------------------------------------------------
Fax | 907-885-2028
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 2241
-----------------------------------------------------
City | PALMER
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99645-2241
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-214-2808
-----------------------------------------------------
Fax | 907-885-2028
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LICENSED PROFESSIONAL COUNSELOR
-----------------------------------------------------
Name | KRISTINA A KINNEY
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 907-355-5773
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------