Interior Alaska DBT & Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

INTERIOR ALASKA DBT & COUNSELING, LLC

Practice address

565 University Ave Ste 4
Fairbanks, AK 99709-3688

Phone

(907) 712-7667

Fax

(907) 202-8341

NPI assigned

Feb 4, 2021

Last updated

Feb 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John M Worrall, PH.D.NPI 1881966414

Title

Psychologist

Phone

(907) 712-7667

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Michael Worrall, PH.D.

  • Cognitive & Behavioral Psychologist
  • Fairbanks, AK
  • NPI 1881966414
  NPD Authorized official

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

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612396800000",
    "number": "1467044123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 70485",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997070485",
            "telephone_number": "907-712-7667",
            "fax_number": "907-202-8341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 UNIVERSITY AVE STE 4",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997093688",
            "telephone_number": "907-712-7667",
            "fax_number": "907-202-8341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERIOR ALASKA DBT & COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-02-04",
        "certification_date": "2021-02-04",
        "status": "A",
        "authorized_official_last_name": "WORRALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "907-712-7667",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2021; 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.