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General NPI Number Information
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NPI Number | 1518724749
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Entity Type | Organization
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Legal Business Name | BEAR CREEK COUNSELING AND TRAUMA RECOVERY, LLC
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Dates
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Enumeration Date | 03/04/2024
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 44539 STERLING HWY STE 209
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City | SOLDOTNA
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State | AK
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Zip | 99669-7960
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Country | US
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Telephone | 904-872-3031
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Fax |
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Provider Business Mailing Address
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Address Line | 44539 STERLING HWY STE 209
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City | SOLDOTNA
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State | AK
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Zip | 99669-7960
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Country | US
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Telephone | 904-872-3031
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY DANIEL BRAKHAGE
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Credential | LPC
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Telephone | 907-252-8445
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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