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General NPI Number Information
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NPI Number | 1992667372
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Entity Type | Organization
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Legal Business Name | DRIFTWOOD COUNSELING LLC
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Dates
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Enumeration Date | 11/24/2025
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Last Update Date | 01/01/2026
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Provider Practice Location Address
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Address Line | 4987 MURPHY DOME RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-5974
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Country | US
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Telephone | 907-347-2972
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Fax |
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Provider Business Mailing Address
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Address Line | 4987 MURPHY DOME RD
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City | FAIRBANKS
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State | AK
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Zip | 99709-5974
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Country | US
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Telephone | 907-888-2082
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | MS. CASSIE THACKER JACKSON
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Credential | M.ED., LPC, NCC
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Telephone | 907-888-2082
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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