Active NPI
Mary Patricia Palko, MSCP, LPC, CDCII
- Professional Counselor
- Anchorage, AK
National Provider Identifier
1366600090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PCOP503
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PCOP503 | AK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Mental Health Counselor
- Anchorage, AK
- NPI 1184263741
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.