Freedom Behavioral Health Alaska LLC
Organization Active NPI Psychiatry Physician · Eagle River, AK
NPI 1003671348 · NPPES record last updated Jul 14, 2026
Key facts
- NPI
- 1003671348
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatry Physician 2084P0800X
- Legal business name
- FREEDOM BEHAVIORAL HEALTH ALASKA LLC
- Practice address
- 10928 Eagle River Rd Ste 254
Eagle River, AK 99577-8080 - Phone
- (907) 696-0221
- Fax
- (877) 875-9556
- NPI assigned
- Feb 15, 2024
- Organization subpart
- No
Authorized official
- Name
- Amelia Doris Ledbetter
- Title
- Credentialing Company
- Phone
- (573) 803-5205
Practitioners 13
-
Cynthia Barraza Guerra, PMHNP-BC
-
Marie Lanora Moore, APRN
-
Nathanael Lenz, LMFT
-
Krystal Lane Speier, LCPC
-
David Michael Wichman, M.D.
-
Barrett Noel Hesson, M.S., L.P.C.
-
Courtney Sherrill Moody, LCSW, LCADC
-
Precious Eyewumi Izeagi, MSN, APRN, PMHNP-BC
-
Andrea Margaret Trescot, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240415002290 | AK | Part B Supplier - Clinic/Group Practice | 4880033513 |
Receives reassigned benefits from 8 practitioners Practice locations: Eagle River, AK; Fairbanks, AK |
National Provider Directory
Locations
10928 Eagle River Rd
Ste 254
Eagle River, AK 99577
Phone (907) 696-0221
3540 International St
Fairbanks, AK 99701
Phone (907) 328-0581
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician |
2084P0800X | Yes |
Addresses
Primary practice location
10928 Eagle River Rd Ste 254
Eagle River, AK 99577-8080
Mailing address
10928 Eagle River Rd Ste 254
Eagle River, AK 99577-8080
Phone (907) 696-0221
Other practice location 1
3540 International St
Fairbanks, AK 99701-7382
Phone (907) 328-0581
Other practice location 2
4015 Lake Otis Pkwy Ste 101
Anchorage, AK 99508-5235
Phone (905) 865-7773
Other providers in Eagle River, AK
- Joanne K Fosdick
- Marela Francisco
- Heidi M Frank
- Fred Meyer Stores Inc
- David Freedman
- Julie Anne Friedli
- Suzie Friedman
- Sharon Lee Frost
- Brandy Gallatin
- Lucy Galloway
All providers in Eagle River, AK · Psychiatry Physician in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.