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NPI Code Detail

MEDICARE: DAISY VANSLYKE BSW

MEDICARE: DAISY VANSLYKE BSW
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
1101YA0400XAddiction (Substance Use Disorder) Counselor4652AK
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1053963926
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAISY VANSLYKE BSW
Provider Business Mailing Address
First Line : 7033 E TUDOR RD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99507-1262
Country : US
Telephone Number : 907-729-6801
Fax Number : 907-729-5180
Provider Business Practice Location Address
First Line : 3149 MOUNTAIN VIEW DR
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3106
Country : US
Telephone Number : 907-793-3235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2019
Last Update Date : 01/05/2026

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Directions to “ DAISY VANSLYKE BSW” Practice Location

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