Provider Demographics
NPI:1518239490
Name:ELBERT, ROSE ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:ROSE
Middle Name:ELIZABETH
Last Name:ELBERT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ROSE
Other - Middle Name:ELIZABETH
Other - Last Name:HIRT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3550 AIRPORT WAY STE 4
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-4772
Mailing Address - Country:US
Mailing Address - Phone:907-378-6086
Mailing Address - Fax:
Practice Address - Street 1:3550 AIRPORT WAY STE 4
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-4772
Practice Address - Country:US
Practice Address - Phone:907-378-6086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMH3237Medicaid