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General NPI Number Information
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NPI Number | 1487709325
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Entity Type | Individual
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Provider Name | H MICHAEL SCHMOKER SR. LCSW
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Gender | Male
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 02/01/2012
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Provider Practice Location Address
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Address Line | 250 CUSHMAN STREET STE 4F
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City | FAIRBANKS
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State | AK
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Zip | 99709-4665
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Country | US
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Telephone | 907-452-4405
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 73525
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City | FAIRBANKS
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State | AK
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Zip | 99707-3525
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Country | US
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Telephone | 907-452-4405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 93
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License Number State | AK
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