MEDICARE: HEALING JOURNEY COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	700	AK

General Provider Information

NPI Number	:	1053679514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING JOURNEY COUNSELING LLC

Provider Business Mailing Address
First Line	:	4141 B ST
Second Line	:	SUITE 306
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5940
Country	:	US
Telephone Number	:	907-952-6260
Fax Number	:	907-222-1078

Provider Business Practice Location Address
First Line	:	4141 B ST
Second Line	:	SUITE 306
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-5940
Country	:	US
Telephone Number	:	907-952-6260
Fax Number	:	907-222-1078

Authorized Official
Title or Position	:	SOLE MEMBER/ OWNER
Name	:	SHERRI LYNN FELTON
Credential	:	MS LPC
Telephone Number	:	907-952-6260

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	05/02/2012

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