Provider Demographics
NPI:1235412958
Name:CARSON, HEIDI ANN
Entity Type:Individual
Prefix:MISS
First Name:HEIDI
Middle Name:ANN
Last Name:CARSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 F ST
Mailing Address - Street 2:COVENANT HOUSE ALASKA
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99501-3533
Mailing Address - Country:US
Mailing Address - Phone:907-339-4205
Mailing Address - Fax:907-272-1466
Practice Address - Street 1:609 F ST
Practice Address - Street 2:COVENANT HOUSE ALASKA
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3533
Practice Address - Country:US
Practice Address - Phone:907-339-4205
Practice Address - Fax:907-272-1466
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health