Krista Ann Pemberton, LCSW

Individual provider Active NPI Clinical Social Worker · Anchorage, AK

NPI 1194029488 · NPPES record last updated Mar 23, 2012

Key facts

NPI
1194029488
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
1023 (AK)
Practice address
2600 Denali St
Suite 450
Anchorage, AK 99503-2746
Phone
(907) 561-0552
Fax
(907) 561-0562
NPI assigned
Dec 31, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pemberton and Young Counseling LLC (2 clinicians)

Practice addresses (Care Compare)

1345 W 9TH Ave
Suite 201
Anchorage, AK 99501-3236
Phone (907) 258-8003

Medicare participation

Medicare fee-for-service enrollment
Enrolled in AK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20110405001144 AK Practitioner - Clinical Social Worker 6002090685 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1023AKMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1023 AK Yes

Addresses

Primary practice location

2600 Denali St
Suite 450
Anchorage, AK 99503-2746

Mailing address

PO Box 92303
Anchorage, AK 99509-2303
Phone (907) 561-0552

Other providers in Anchorage, AK

All providers in Anchorage, AK · Clinical Social Worker in Alaska

Sources for this page

Verify at the official NPI Registry.