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NPI Code Detail

MEDICARE: MR. DANIEL PAUL LIGHT LPC

MEDICARE: MR. DANIEL PAUL LIGHT LPC
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
1101YP2500XProfessional CounselorPCOP426AK

General Provider Information

NPI Number : 1508427386
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DANIEL PAUL LIGHT LPC
Provider Business Mailing Address
First Line : PO BOX 382
Second Line :
City : HOUSTON
State : AK
Zip : 99694-0382
Country : US
Telephone Number : 907-521-3240
Fax Number :
Provider Business Practice Location Address
First Line : 26731 W POINT MACKENZIE RD
Second Line :
City : WASILLA
State : AK
Zip : 99623-8709
Country : US
Telephone Number : 907-376-4534
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2019
Last Update Date : 10/22/2021

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Directions to “ MR. DANIEL PAUL LIGHT LPC” Practice Location

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