Provider Demographics
NPI:1841415320
Name:PSYCHOLOGY RESOURCES, PC
Entity Type:Organization
Organization Name:PSYCHOLOGY RESOURCES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:F
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:907-272-4407
Mailing Address - Street 1:2600 DENALI ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-2739
Mailing Address - Country:US
Mailing Address - Phone:907-272-4407
Mailing Address - Fax:907-272-4463
Practice Address - Street 1:2600 DENALI ST
Practice Address - Street 2:SUITE 302
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2746
Practice Address - Country:US
Practice Address - Phone:907-272-4407
Practice Address - Fax:907-272-4463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKAA478101Y00000X
AKAA481101Y00000X
AKAA139101Y00000X
AKAA056101Y00000X
AKAA503101YM0800X
AKAA0186103T00000X
AKAA482103T00000X
AKAA313103T00000X
AKAA310103T00000X
AKAA545103T00000X
AK480103T00000X
AKA0069106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty