Provider Demographics
NPI:1629504634
Name:KENAI RIVER COUNSELING
Entity Type:Organization
Organization Name:KENAI RIVER COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BARLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:602-376-3146
Mailing Address - Street 1:44539 STERLING HWY
Mailing Address - Street 2:#213
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7920
Mailing Address - Country:US
Mailing Address - Phone:602-376-3146
Mailing Address - Fax:
Practice Address - Street 1:44539 STERLING HWY
Practice Address - Street 2:#213
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7920
Practice Address - Country:US
Practice Address - Phone:602-376-3146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115272101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty