Jason Brent Fedeli, MA, LPC-S
Individual provider Active NPI Professional Counselor · Anchorage, AK
NPI 1407199656 · NPPES record last updated Dec 23, 2024
Key facts
- NPI
- 1407199656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 119538 (AK)
- Practice address
- 9330 Vanguard Dr Ste 202
Anchorage, AK 99507-5393 - Phone
- (907) 202-2527
- NPI assigned
- Apr 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9330 Vanguard Dr
Suite 202
Anchorage, AK 99507-5393
Phone (907) 315-1955
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AK
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240402001220 | AK | Practitioner - Mental Health Counselor | 2567800162 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 119538 | AK | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jason Brent Fedeli Professional Counseling LLC | Current |
Accepting new patients | |
| Ge Family Services LLC | Professional | Current |
Accepting new patients |
| Alaska Full Circle Counseling Solutions LLC | Past | Accepting new patients |
Locations
9330 Vanguard Dr
Ste 202
Anchorage, AK 99507
Phone (907) 315-1955
341 W Tudor Rd
Ste 209
Anchorage, AK 99503
Phone (855) 508-1075
3521 Mountain View Dr
Anchorage, AK 99508
Phone (907) 792-2300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Professional Counselor | 101YP2500X | 119538 | AK | Yes |
Addresses
Primary practice location
9330 Vanguard Dr Ste 202
Anchorage, AK 99507-5393
Mailing address
9330 Vanguard Dr Ste 202
Anchorage, AK 99507-5393
Phone (907) 202-2527
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119538 | Other | AK | STATE OF ALASKA LPC LICENSE |
| 2093603 | Other | AK | ALASKA BUSINESS LICENSE |
| 1013676055 | Other | AK | NPI-2 |
Other providers in Anchorage, AK
- Fe'S Assisted Living Home
- Donna A Fearey
- Jennifer Lynn Featherston
- Jeremy Featherston
- Laya Corinn Fedele
- Shelley Lynn Federspiel
- Providence Feh
- Feh'S Humanitarina LLC
- Jerod Feight
- Ronald A Feigin
All providers in Anchorage, AK · Professional 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 Dec 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.