Provider Demographics
NPI:1114275369
Name:BROKOFSKY, DANA B (LPC)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:B
Last Name:BROKOFSKY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 W 31ST AVE
Mailing Address - Street 2:STE. 400
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-3678
Mailing Address - Country:US
Mailing Address - Phone:907-771-0536
Mailing Address - Fax:907-771-0537
Practice Address - Street 1:1407 W 31ST AVE
Practice Address - Street 2:STE. 400
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-3678
Practice Address - Country:US
Practice Address - Phone:907-771-0536
Practice Address - Fax:907-771-0537
Is Sole Proprietor?:No
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK749101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional