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NPI Code Detail

MEDICARE: CHRISTINA MCGAUTHIAR LCSW, CDC I

MEDICARE: CHRISTINA MCGAUTHIAR LCSW, CDC I
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker1121AK

General Provider Information

NPI Number : 1396075818
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA MCGAUTHIAR LCSW, CDC I
Provider Business Mailing Address
First Line : 1675 C ST
Second Line : STE 201
City : ANCHORAGE
State : AK
Zip : 99501-5153
Country : US
Telephone Number : 907-279-9634
Fax Number : 907-279-0148
Provider Business Practice Location Address
First Line : 8012 STEWART MOUNTAIN DR
Second Line :
City : EAGLE RIVER
State : AK
Zip : 99577-9013
Country : US
Telephone Number : 907-694-3336
Fax Number : 907-279-0148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2010
Last Update Date : 11/13/2011

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Directions to “ CHRISTINA MCGAUTHIAR LCSW, CDC I” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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