Princilla Patrice Ursery, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401017280 Issued in MI

Practice address

3590 Holden Rd
Fairbanks, AK 99709-4950

Phone

(907) 456-6445

Fax

(866) 898-9031

NPI assigned

Jun 14, 2016

Last updated

Nov 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1497105126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 472",
            "city": "DELTA JUNCTION",
            "state": "AK",
            "postal_code": "997370472",
            "telephone_number": "907-987-6052",
            "fax_number": "866-898-9031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3590 HOLDEN RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997094950",
            "telephone_number": "907-456-6445",
            "fax_number": "866-898-9031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19450 Charest St",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482341670",
            "country_code": "US",
            "telephone_number": "907-987-6052",
            "fax_number": "866-898-9031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "URSERY",
        "first_name": "PRINCILLA",
        "middle_name": "PATRICE",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "172683",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401017280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Alaska Fairbanks Center for Health & Counseling
• University Women's Health LLC
• Susan Celeste Updegraff, SLPA
• Kylee Urbanski
• Devon Urquhart, BHS
• Ana Vakauta
• Alena Katherine Valles
• Emily Ann Van Gorp, PT
• Hannah Corinne Van Laeken, MSW
• Debra Vance, M.ED.

• Mental Health Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.