Provider Demographics
NPI:1437483377
Name:SLINEY, LAUREL A (BA)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:A
Last Name:SLINEY
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:LAUREL
Other - Middle Name:A
Other - Last Name:BENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 70731
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99707
Mailing Address - Country:US
Mailing Address - Phone:907-456-5573
Mailing Address - Fax:
Practice Address - Street 1:3830 S. CUSHMAN ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701
Practice Address - Country:US
Practice Address - Phone:907-455-5304
Practice Address - Fax:907-455-1460
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-24
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH0157Medicaid
AKK0000WCHCPMedicare PIN