Tanya Ivanivna Hallgren, M.ED., LPC – Counselor

Key facts

NPI: 1104067974
Entity type: Individual (NPI type 1)
Primary specialty: Counselor 101Y00000X
License: LPC#568 (AK)
Practice address: 2960 Tongass Avenue
First Floor Ketchikan Indian Community Tribal Health CL
Ketchikan, AK 99901
Phone: (907) 228-4917
Fax: (907) 228-4920
NPI assigned: Mar 9, 2009
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Education

State licenses

License	State	Type	Specialty
LPC#568	AK	MD	Counselor
CERTIFICATE #3429	AK	MD	Addiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Counselor	101Y00000X	LPC#568	AK	Yes
Addiction (Substance Use Disorder) Counselor	101YA0400X	CERTIFICATE #3429	AK

Addresses

Primary practice location

2960 Tongass Avenue
First Floor Ketchikan Indian Community Tribal Health CL
Ketchikan, AK 99901

Mailing address

2960 Tongass Avenue
First Floor Ketchikan Indian Community Tribal Health CL
Ketchikan, AK 99901
Phone (907) 228-4917

Other names

Tetyana Ivanivna Babyak Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 9, 2009.

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1104067974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVENUE",
            "address_2": "FIRST FLOOR KETCHIKAN INDIAN COMMUNITY TRIBAL HEALTH CL",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-228-4917",
            "fax_number": "907-228-4920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVENUE",
            "address_2": "FIRST FLOOR KETCHIKAN INDIAN COMMUNITY TRIBAL HEALTH CL",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-228-4917",
            "fax_number": "907-228-4920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLGREN",
        "first_name": "TANYA",
        "middle_name": "IVANIVNA",
        "credential": "M.ED., LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AK",
            "license": "LPC#568",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "CERTIFICATE #3429",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TETYANA",
            "last_name": "BABYAK",
            "middle_name": "IVANIVNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ketchikan, AK

All providers in Ketchikan, AK · Counselor in Alaska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.