Provider Demographics
NPI:1417450396
Name:STRANGE, KATHRYN BAYER (MS, NCC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:BAYER
Last Name:STRANGE
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 PEGER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-5169
Mailing Address - Country:US
Mailing Address - Phone:907-371-1304
Mailing Address - Fax:907-375-1387
Practice Address - Street 1:1423 PEGER RD
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-5169
Practice Address - Country:US
Practice Address - Phone:907-371-1304
Practice Address - Fax:907-371-1387
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-16
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KS3221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional