Provider Demographics
NPI:1083017818
Name:SOOY, ERIK SHAMUS (LPC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:SHAMUS
Last Name:SOOY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:ERIK
Other - Middle Name:SHAMUS
Other - Last Name:SOOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:7033 E TUDOR RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-1262
Mailing Address - Country:US
Mailing Address - Phone:907-729-8901
Mailing Address - Fax:907-729-8607
Practice Address - Street 1:4341 TUDOR CENTRE DR # 300
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5904
Practice Address - Country:US
Practice Address - Phone:907-729-8901
Practice Address - Fax:907-729-8607
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00183400101YM0800X
AK190439101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health