Upstream Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

1069542 Issued in AK

Legal business name

UPSTREAM COUNSELING LLC

Practice address

741 Sesame St Ste 1B
Anchorage, AK 99503-6657

Phone

(907) 444-4867

Fax

(844) 628-1611

NPI assigned

Apr 16, 2018

Organization subpart

No

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

Authorized official

Name

Maria Lynn Ballard, LPCNPI 1295111904

Title

Ceo

Phone

(907) 297-9639

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Maria Lynn Ballard

  • Mental Health Counselor
  • Anchorage, AK
  • NPI 1295111904
  NPD Authorized official

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

{
    "created_epoch": "1523836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1376030288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 SESAME ST STE 1B",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036657",
            "telephone_number": "907-444-4867",
            "fax_number": "844-628-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 SESAME ST STE 1B",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995036657",
            "telephone_number": "907-444-4867",
            "fax_number": "844-628-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPSTREAM COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-16",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "BALLARD",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "907-297-9639",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AK",
            "license": "1069542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.