Erik Edenshaw

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

615 Bidwill Ave Ste 103
Fairbanks, AK 99701-7587

Phone

(907) 452-1648

NPI assigned

Nov 19, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maniilaq Association

  • Professional Counselor
  • Kotzebue, AK
  • NPI 1780705608
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647907200000",
    "number": "1013284017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 MCKINLEY VIEW DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997121329",
            "telephone_number": "907-306-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 BIDWILL AVE STE 103",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017587",
            "telephone_number": "907-452-1648"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "733 second avenue",
            "address_purpose": "LOCATION",
            "city": "Kotzebue",
            "state": "AK",
            "postal_code": "997520571",
            "country_code": "US",
            "telephone_number": "907-442-7647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDENSHAW",
        "first_name": "ERIK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-19",
        "last_updated": "2022-03-22",
        "certification_date": "2022-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle Ebbesson, MA LMT
• Kristina Eberhardt, BCBA
• Harold Echo-Hawk
• Amanda Eckert
• Lisabeth Eddy, M.ED
• Denise Edgerton, BA
• Norman Edwards, BA
• Xavier Deshae Edwards
• Liisia Rae Edwardsen, CHAIII
• Jason Carlos Edwin-Matos

• Mental Health Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.