NPIMap

Organization Active NPI

Summit Therapy LLC

  • Clinical Social Worker
  • Fairbanks, AK
National Provider Identifier
1063288348
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUMMIT THERAPY LLC
Practice address
250 Cushman St Ste 4F
Fairbanks, AK 99701-4665
Phone
(907) 978-1943
Fax
(360) 838-4806
NPI assigned
Nov 28, 2023
Last updated
Nov 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Carrie L Miniard, LCSWNPI 1285239087
Title
Social Worker
Phone
(907) 978-1943

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

250 Cushman St Ste 4F
Fairbanks, AK 99701-4665

Mailing address

700 Sleater Kinney Rd SE Ste B189
Lacey, WA 98503-1150
Phone (907) 978-1943

National Provider Directory

National Provider Directory
Tax ID family
Summit Therapy LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1063288348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 SLEATER KINNEY RD SE STE B189",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985031150",
            "telephone_number": "907-978-1943",
            "fax_number": "360-838-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 4F",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-978-1943",
            "fax_number": "360-838-4806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-28",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "MINIARD",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "907-978-1943",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2024; 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.