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NPI Code Detail

MEDICARE: DEBORRA FIELDS M.S. LPC.

MEDICARE: DEBORRA FIELDS M.S. 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
1171M00000XCase Manager/Care Coordinator276AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629268131
Entity Type Code : Organization
Provider Name (Legal Business Name) : DEBORRA FIELDS M.S. LPC.
Provider Business Mailing Address
First Line : 2825 W 42ND AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99517-2830
Country : US
Telephone Number : 907-243-5130
Fax Number : 907-248-8350
Provider Business Practice Location Address
First Line : 2825 W 42ND AVE
Second Line :
City : ANCHORAGE
State : AK
Zip : 99517-2830
Country : US
Telephone Number : 907-243-5130
Fax Number : 907-248-8350
Authorized Official
Title or Position : CARE COORDINATOR
Name : DEBORRA FIELDS
Credential : M.S
Telephone Number : 907-243-5130
Provider Enumeration Date : 07/31/2007
Last Update Date : 07/31/2007

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