Provider Demographics
NPI:1619057403
Name:LESTER, CHARLES FEDERICK JR (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FEDERICK
Last Name:LESTER
Suffix:JR
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 DENALI
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2740
Mailing Address - Country:US
Mailing Address - Phone:907-272-4407
Mailing Address - Fax:907-272-4463
Practice Address - Street 1:2600 DENALI
Practice Address - Street 2:SUITE 302
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2740
Practice Address - Country:US
Practice Address - Phone:907-272-4407
Practice Address - Fax:907-272-4463
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA310103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist