Kayla Alexis Leu Clark

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

1521 S Cushman St
Fairbanks, AK 99701-6203

Phone

(907) 750-6270

NPI assigned

Sep 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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.

• Tanana Chiefs Conference

  • Community/Behavioral Health Agency
  • Fairbanks, AK
  • NPI 1841835980
  NPD

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1093439481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016203",
            "telephone_number": "907-750-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997016203",
            "telephone_number": "907-750-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEU CLARK",
        "first_name": "KAYLA",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Medical",
            "affiliation": "N",
            "address_1": "1521 S Cushman St",
            "city": "Fairbanks",
            "state": "AK",
            "country_code": "US",
            "postal_code": "997016203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jill Denise Lesseig, RN
• Jenny R Lessner, MD
• Androcles Jay Lester, MD
• Let US Care Assisted Living Home
• Regina M. Letonek, LMT
• Max Levitt, MD
• A. Randy Lewis, LCSW
• Brendan Lewis, PT, DPT
• Daryl Lewis
• Diane Lewis, RN

• Addiction (Substance Use Disorder) Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Addiction (Substance Use Disorder) Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.