Lynn Roberta Harrison, M.ED

Individual provider Active NPI Marriage & Family Therapist · Fairbanks, AK

NPI 1003022856 · NPPES record last updated Jul 10, 2015

Key facts

NPI
1003022856
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFT M 193 (AK)
Practice address
3504 Industrial
Fairbanks, AK 99701
Phone
(907) 479-8450
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
CDC IAKMDAddiction (Substance Use Disorder) Counselor
MH 2389FLMDMental Health Counselor
MFT M 193AKMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CDC I AK
Mental Health Counselor 101YM0800X MH 2389 FL
Marriage & Family Therapist 106H00000X MFT M 193 AK Yes

Addresses

Primary practice location

3504 Industrial
Fairbanks, AK 99701

Mailing address

PO Box 74083
Fairbanks, AK 99707-4083
Phone (907) 479-8450

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Marriage & Family Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.