Active NPI
Sally Ann Caldwell, LPC-S, MAC, SEP
- Professional Counselor
- Fairbanks, AK
National Provider Identifier
1336387158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 562
- Practice address
- 1929 Airport Way Ste B
Fairbanks, AK 99701-4009 - Phone
- (907) 891-7877
- Fax
- (907) 917-4887
- NPI assigned
- Feb 2, 2009
- Last updated
- Sep 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 507483 | AK | |
| Professional Counselor | 101YP2500X | 562 | AK | Primary |
Addresses
Primary practice location
1929 Airport Way Ste B
Fairbanks, AK 99701-4009
Mailing address
1929 Airport Way Ste B
Fairbanks, AK 99701-4009
Phone (907) 891-7877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 13892355 | Other | AK | CAQH |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Quest@questandcounselingandwellness.com | Health Information Exchange (HIE) |
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 |
|---|---|---|---|
| 507483 | AK | MD | Addiction (Substance Use Disorder) Counselor |
| 562 | AK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Quest Counseling and Wellness LLC | Professional | Current | Accepting new patients |
| Fairbanks Psychiatric and Neurological Clinic a Prof Corp | Past | Accepting new patients |
Locations
1929 Airport Way
Ste B
Fairbanks, AK 99701
Phone (907) 347-6900
Interoperability endpoints
- quest@questandcounselingandwellness.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Fairbanks, AK
- NPI 1205522950
-
- Neurology Physician
- Fairbanks, AK
- NPI 1518075100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726185600000",
"number": "1336387158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1929 AIRPORT WAY STE B",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014009",
"telephone_number": "907-891-7877",
"fax_number": "907-917-4887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1929 AIRPORT WAY STE B",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997014009",
"telephone_number": "907-891-7877",
"fax_number": "907-917-4887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDWELL",
"first_name": "SALLY",
"middle_name": "ANN",
"credential": "LPC-S, MAC, SEP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-02",
"last_updated": "2024-09-13",
"certification_date": "2024-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AK",
"license": "507483",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AK",
"license": "562",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH",
"identifier": "13892355",
"state": "AK"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Quest@questandcounselingandwellness.com",
"affiliation": "N",
"endpointDescription": "encrypted clinic email",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "PHI",
"address_1": "1929 Airport Way Ste B",
"city": "Fairbanks",
"state": "AK",
"country_code": "US",
"postal_code": "997014009",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.