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NPI Code Detail

MEDICARE: MR. ELI MICHAEL LCSW, CDC1

MEDICARE: MR. ELI MICHAEL LCSW, CDC1
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
1104100000XSocial WorkerAK
2101YA0400XAddiction (Substance Use Disorder) Counselor4582AK
31041C0700XClinical Social Worker172440AK

General Provider Information

NPI Number : 1073009379
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ELI MICHAEL LCSW, CDC1
Provider Business Mailing Address
First Line : 3300 ARCTIC BLVD
Second Line : STE 201 PMB 1043
City : ANCHORAGE
State : AK
Zip : 99503-4579
Country : US
Telephone Number : 907-268-4234
Fax Number : 877-907-0952
Provider Business Practice Location Address
First Line : 821 N ST STE 102
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-3285
Country : US
Telephone Number : 907-268-4234
Fax Number : 877-907-0952
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2018
Last Update Date : 03/05/2026

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