Organization Active NPI

Deeper Light Psychotherapy

  • Mental Health Counselor
  • Juneau, AK
National Provider Identifier
1912475260
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DEEPER LIGHT PSYCHOTHERAPY
Practice address
174 S Franklin St Ste 211
Juneau, AK 99801-1362
Phone
(907) 419-7048
NPI assigned
Nov 5, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Mary Doris Fitzgerald, MS, LPC
Title
Psychotherapist/Owner
Phone
(907) 419-7048

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

174 S Franklin St Ste 211
Juneau, AK 99801-1362

Mailing address

174 S Franklin St Ste 211
Juneau, AK 99801-1362
Phone (907) 419-7048

National Provider Directory

National Provider Directory

Locations

174 S Franklin St
Ste 211
Juneau, AK 99801
Phone (907) 419-7048

NPI Registry JSON

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1912475260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 S FRANKLIN ST STE 211",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011362",
            "telephone_number": "907-419-7048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 S FRANKLIN ST STE 211",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011362",
            "telephone_number": "907-419-7048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPER LIGHT PSYCHOTHERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "DORIS",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST/OWNER",
        "authorized_official_telephone_number": "907-419-7048",
        "authorized_official_credential": "MS, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.