Adiella Callahan, MED
Individual provider Active NPI Professional Counselor · Fairbanks, AK
NPI 1306390448 · NPPES record last updated Oct 13, 2025
Key facts
- NPI
- 1306390448
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 160419 (AK)
- Practice address
- 3550 Airport Way Ste 3
Fairbanks, AK 99709-4772 - Phone
- (907) 531-5991
- Fax
- (907) 921-5098
- NPI assigned
- Aug 5, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240513001567 | AK | Practitioner - Mental Health Counselor | 7517307473 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Education
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interior AIDS Association | Addiction (Substance Use Disorder) | Current |
Accepting new patients |
| Interior AIDS Association | Past |
Accepting new patients |
Locations
710 3rd Ave
Fairbanks, AK 99701
Phone (907) 452-2222
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Professional Counselor | 101YP2500X | 160419 | AK | Yes |
Addresses
Primary practice location
3550 Airport Way Ste 3
Fairbanks, AK 99709-4772
Mailing address
PO Box 71248
Fairbanks, AK 99707-1248
Phone (907) 452-4222
Other practice location 1
710 3rd Ave
Fairbanks, AK 99701-4455
Phone (907) 452-4222 ext. 113
Other providers in Fairbanks, AK
- Patrick Daniel Cahill
- Sally Ann Caldwell
- Cassia Calhoun
- Natalie Calhoun
- Shalanda Calhoun
- Leslie Callaway
- Calmkey Telehealth Connection LLC
- Laura Gayle Calvert
- Michaela Cameron
- Katherine E Cammack
All providers in Fairbanks, AK · Professional 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 Oct 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.