Active NPI
Amanda Renee Kookesh, LPC
- Counselor
- Anchorage, AK
National Provider Identifier
1609557883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 162904
- Practice address
- 308 G St Ste 311
Anchorage, AK 99501-2153 - Phone
- (907) 519-0353
- NPI assigned
- Jul 31, 2023
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 162904 | AK | Primary |
Addresses
Primary practice location
308 G St Ste 311
Anchorage, AK 99501-2153
Mailing address
308 G St Ste 311
Anchorage, AK 99501-2153
Phone (907) 519-0353
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 9, 2025 through May 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 162904 | AK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690761600000",
"number": "1609557883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "308 G ST STE 311",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995012153",
"telephone_number": "907-519-0353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 G ST STE 311",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995012153",
"telephone_number": "907-519-0353"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOOKESH",
"first_name": "AMANDA",
"middle_name": "RENEE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-07-31",
"last_updated": "2023-07-31",
"certification_date": "2023-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AK",
"license": "162904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.