Individual provider Active NPI

Mary Patricia Palko, MSCP, LPC, CDCII

  • Professional Counselor
  • Anchorage, AK
National Provider Identifier
1366600090
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PCOP503 Issued in AK
Practice address
3760 Piper St Ste 1108
Anchorage, AK 99508-4683
Phone
(907) 212-6900
Fax
(907) 212-6936
NPI assigned
May 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PCOP503 AK Primary

Addresses

Primary practice location

3760 Piper St Ste 1108
Anchorage, AK 99508-4683

Mailing address

PO Box 4105
Portland, OR 97208-4105
Phone (866) 907-1068

Other practice location 1

2211 Arca Dr
Anchorage, AK 99508-3462
Phone (907) 777-0168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 19, 2024 through Jun 19, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PCOP503AKMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Telepsychology Past Accepting new patients

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519862400000",
    "number": "1366600090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4105",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084105",
            "telephone_number": "866-907-1068",
            "fax_number": "425-917-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 PIPER ST STE 1108",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084683",
            "telephone_number": "907-212-6900",
            "fax_number": "907-212-6936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Arca Dr",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995083462",
            "country_code": "US",
            "telephone_number": "907-777-0168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PALKO",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "credential": "MSCP, LPC, CDCII",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2018-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "PCOP503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.