Headwaters Wellness and Counseling LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PCOC613 Issued in AK

Legal business name

HEADWATERS WELLNESS AND COUNSELING LLC

Practice address

250 Cushman St
Suite 4J
Fairbanks, AK 99701-4665

Phone

(907) 456-2256

Fax

(907) 456-2260

NPI assigned

Nov 28, 2016

Organization subpart

No

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

Authorized official

Name

Liz Pawelko, LPC

Title

Owner

Phone

(907) 456-2256

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1480291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512950400000",
    "number": "1962945709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST STE 5",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-456-2256",
            "fax_number": "907-456-2260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CUSHMAN ST",
            "address_2": "SUITE 4J",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014665",
            "telephone_number": "907-456-2256",
            "fax_number": "907-456-2260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEADWATERS WELLNESS AND COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-28",
        "last_updated": "2017-12-11",
        "status": "A",
        "authorized_official_last_name": "PAWELKO",
        "authorized_official_first_name": "LIZ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-456-2256",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "AK",
            "license": "PCOC613",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Lynn Hawk
• Giles Andrew Hawthorn, B.S., B.S.W.
• Lisa Hay
• Trista Haycraft, LMT
• Kelly Ann Hayungs, MSW, LCSW
• Healing Light Advocacy, L.L.C.
• Healthy Connections
• Minnie Healy, BHA
• Heartland Care Assisted Living
• Marshall Heaster, PHARMD

• Professional Counselor in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Professional Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; 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.