Susie Sam

Individual provider Active NPI Community/Behavioral Health Agency · Galena, AK

NPI 1629950563 · NPPES record last updated Jul 22, 2025

Key facts

NPI
1629950563
Entity type
Individual (NPI type 1)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Practice address
PO Box 154
Galena, AK 99741-0154
Phone
(907) 656-7215
Fax
(907) 656-7215
NPI assigned
Jul 22, 2025
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

PO Box 154
Galena, AK 99741-0154

Mailing address

200 1St Ave
Fairbanks, AK 99701-4805
Phone (907) 452-8251

Other providers in Galena, AK

All providers in Galena, AK · Community/Behavioral Health Agency in Alaska

Sources for this page

Verify at the official NPI Registry.