Active NPI
Phoebe Proudfoot
- Mental Health Counselor
- Anchorage, AK
National Provider Identifier
1477930311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1076
- Practice address
- 1840 Bragaw St Ste 110
Anchorage, AK 99508-3463 - Phone
- (907) 334-0135
- NPI assigned
- Apr 29, 2015
- Last updated
- Apr 29, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 1076 | AK | Primary |
Addresses
Primary practice location
1840 Bragaw St Ste 110
Anchorage, AK 99508-3463
Mailing address
1840 Bragaw St Ste 110
Anchorage, AK 99508-3463
Phone (907) 334-0135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1076 | Other | AK | LCSW |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1076 | AK | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430265600000",
"number": "1477930311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1840 BRAGAW ST STE 110",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995083463",
"telephone_number": "907-334-0135"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1840 BRAGAW ST STE 110",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995083463",
"telephone_number": "907-334-0135"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PROUDFOOT",
"first_name": "PHOEBE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-29",
"last_updated": "2015-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AK",
"license": "1076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCSW",
"identifier": "1076",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
- Madeleine Mae Huan Pronovost, PT, DPT
- Katia Pronzati, RN
- Prosperity House, LLC
- Lynne Prossick, LCSW
- Tonie Protzman, MS
- Sarah Provence
- Providence Anchorage Anesthesia Medical Group, P.C.
- Providence Health & Services - Washington (Providence Lifeline)
- Providence Health & Services - Washington (Providence Alaska Medical Center)
- Providence Health & Services - Washington (Providence Extended Care Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.