Active NPI
Lynda Mae Crow
- Addiction (Substance Use Disorder) Counselor
- Fairbanks, AK
National Provider Identifier
1114122629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2074
- Practice address
- 3051 N Van Horn Rd
Fairbanks, AK 99701-7319 - Phone
- (907) 451-1170
- NPI assigned
- Jun 15, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2074 | AK | Primary |
Addresses
Primary practice location
3051 N Van Horn Rd
Fairbanks, AK 99701-7319
Mailing address
660 Wilcox Ave Apt 18
P.O. Box 74601
Fairbanks, AK 99709-3649
Phone (907) 451-1170
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2074 | AK | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114122629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 WILCOX AVE APT 18",
"address_2": "P.O. BOX 74601",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093649",
"telephone_number": "907-451-1170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3051 N VAN HORN RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997017319",
"telephone_number": "907-451-1170"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROW",
"first_name": "LYNDA",
"middle_name": "MAE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AK",
"license": "2074",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.