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NPI Code Detail

MEDICARE: MRS. JENNIFER AMANDA CASURELLA MA, LPC

MEDICARE: MRS. JENNIFER AMANDA CASURELLA MA, 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 Counselor523AK

General Provider Information

NPI Number : 1881727196
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER AMANDA CASURELLA MA, LPC
Provider Business Mailing Address
First Line : PO BOX 241361
Second Line :
City : ANCHORAGE
State : AK
Zip : 99524-1361
Country : US
Telephone Number : 907-885-0990
Fax Number :
Provider Business Practice Location Address
First Line : 517 W NORTHERN LIGHTS BLVD
Second Line :
City : ANCHORAGE
State : AK
Zip : 99503-2503
Country : US
Telephone Number : 907-885-0990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 11/16/2016

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