Provider Demographics
NPI:1851663793
Name:RANSOM, LINDA ANASTASTIA (LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ANASTASTIA
Last Name:RANSOM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 N KNIK ST
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7049
Mailing Address - Country:US
Mailing Address - Phone:907-376-9502
Mailing Address - Fax:
Practice Address - Street 1:491 N KNIK ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7049
Practice Address - Country:US
Practice Address - Phone:907-376-9502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK112101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional