Provider Demographics
NPI:1619154010
Name:CARD, MINNIE E (MS, LPC)
Entity Type:Individual
Prefix:
First Name:MINNIE
Middle Name:E
Last Name:CARD
Suffix:
Gender:F
Credentials:MS, LPC
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 102266
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99510-2266
Mailing Address - Country:US
Mailing Address - Phone:907-360-2513
Mailing Address - Fax:907-337-3391
Practice Address - Street 1:4325 LAUREL ST
Practice Address - Street 2:SUITE 101A
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5338
Practice Address - Country:US
Practice Address - Phone:907-360-2513
Practice Address - Fax:907-337-3391
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKLPC 440101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health