Provider Demographics
NPI:1568065985
Name:LOOSLI, VERNA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:VERNA
Middle Name:MARIE
Last Name:LOOSLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7090
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:HI
Mailing Address - Zip Code:96737-7090
Mailing Address - Country:US
Mailing Address - Phone:907-947-9255
Mailing Address - Fax:
Practice Address - Street 1:1961 BLUEGRASS CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99502-5404
Practice Address - Country:US
Practice Address - Phone:907-947-9255
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKCSWS3121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical