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NPI Code Detail

MEDICARE: NADA SEIDL

MEDICARE: NADA SEIDL
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) Counselor4940AK
2101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1194462077
Entity Type Code : Individual
Provider Name (Legal Business Name) : NADA SEIDL
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 : 4130 SAN ERNESTO AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99508-2875
Country : US
Telephone Number : 907-729-5070
Fax Number : 907-729-5180
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2022
Last Update Date : 03/31/2026

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Directions to “ NADA SEIDL ” Practice Location

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