Active NPI
Jennifer Attla
- Mental Health Counselor
- Fairbanks, AK
National Provider Identifier
1235358680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1408 19TH Ave RM 359
Fairbanks, AK 99701-5903 - Phone
- (907) 459-3800
- NPI assigned
- Apr 24, 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
1408 19TH Ave RM 359
Fairbanks, AK 99701-5903
Mailing address
PO Box 74814
Fairbanks, AK 99707-4814
Phone (907) 457-4947
Other names 1
- Jennifer Captain
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235358680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 74814",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997074814",
"telephone_number": "907-457-4947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1408 19TH AVE RM 359",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997015903",
"telephone_number": "907-459-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATTLA",
"first_name": "JENNIFER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "CAPTAIN",
"code": "1",
"type": "Former Name"
}
]
}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.