Heidi Eileen Rose, MFT

Individual provider Active NPI Marriage & Family Therapist · Fairbanks, AK

NPI 1487301974 · NPPES record last updated Mar 4, 2022

Key facts

NPI
1487301974
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
Practice address
3504 Industrial Ave Ste 214
Fairbanks, AK 99701-7390
Phone
(907) 452-4673
NPI assigned
Mar 4, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Grace in Motion Past
since Mar 6, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Yes

Addresses

Primary practice location

3504 Industrial Ave Ste 214
Fairbanks, AK 99701-7390

Mailing address

4005 Teal Ave
Fairbanks, AK 99709-3521
Phone (907) 712-4300

Other providers in Fairbanks, AK

All providers in Fairbanks, AK · Marriage & Family Therapist in Alaska

Sources for this page

Verify at the official NPI Registry.