MEDICARE: LORNA-LEI SUA'AVA

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1083579585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORNA-LEI SUA'AVA

Provider Business Mailing Address
First Line	:	PO BOX 876741
Second Line	:
City	:	WASILLA
State	:	AK
Zip	:	99687-6741
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 S SNODGRASS DR
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-9149
Country	:	US
Telephone Number	:	907-373-4732
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ LORNA-LEI SUA'AVA ” Practice Location

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