Lisa Root, PSYD
Individual provider Active NPI Mental Health Counselor · Fairbanks, AK
NPI 1376986802 · NPPES record last updated Apr 15, 2013
Key facts
- NPI
- 1376986802
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 012375 (CO)
- Practice address
- 442 Hagelbarger Ave
Fairbanks, AK 99712-1917 - Phone
- (907) 350-4353
- NPI assigned
- Apr 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 012375 | CO | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 012375 | CO | Yes |
Addresses
Primary practice location
442 Hagelbarger Ave
Fairbanks, AK 99712-1917
Mailing address
442 Hagelbarger Ave
Fairbanks, AK 99712-1917
Phone (907) 350-4353
Other providers in Fairbanks, AK
- Hailee Renee Romig
- Catherine Romine
- Irmgard Jo Romine
- Ronald M. Teel DDS, PC
- Traci Lynn Roon
- Nikki Rosauer
- Carol J Rose
- Heidi Eileen Rose
- Jeri Rosenbloom
- Danay Rosendahl
All providers in Fairbanks, AK · Mental Health 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 Apr 15, 2013. 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.