Dorothy Ella Bekoalok
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Fairbanks, AK
NPI 1376751925 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1376751925
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- DA4380 (AK)
- Practice address
- 122 First Avenue
Suite 600
Fairbanks, AK 99701 - Phone
- (907) 452-8251
- Fax
- (907) 459-3835
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DA4380 | AK | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | DA4380 | AK | Yes |
Addresses
Primary practice location
122 First Avenue
Suite 600
Fairbanks, AK 99701
Mailing address
122 First Avenue
Suite 600
Fairbanks, AK 99701
Phone (907) 452-8251
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DA4380 | Medicaid | AK |
Other providers in Fairbanks, AK
- Bernice Charlene Beddoe
- Amanda Bedford
- Thomas Bedford
- Brandee Beers
- Matilda Behnke-Cheatham
- Lisa Marie Belcher
- Lenamarie Ann Belgarde
- Julia Bell
- Kristal Lynn Bell
- Monica Aide Bell
All providers in Fairbanks, AK · Addiction (Substance Use Disorder) 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 Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.