MEDICARE: MARTI TRYCK LCSW

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	1277	AK

General Provider Information

NPI Number	:	1518350859
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTI TRYCK LCSW

Provider Business Mailing Address
First Line	:	3606 CARLETON AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99517-1539
Country	:	US
Telephone Number	:	907-229-2885
Fax Number	:

Provider Business Practice Location Address
First Line	:	2207 SPENARD RD STE 201
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-1617
Country	:	US
Telephone Number	:	907-229-2885
Fax Number	:

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

Provider Enumeration Date	:	03/11/2015
Last Update Date	:	03/11/2015

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Directions to “ MARTI TRYCK LCSW” Practice Location

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