Provider Demographics
NPI:1942440573
Name:LANSING, JEFFREY M (LPC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:M
Last Name:LANSING
Suffix:
Gender:M
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:PO BOX 1381
Mailing Address - Street 2:
Mailing Address - City:DELTA JUNCTION
Mailing Address - State:AK
Mailing Address - Zip Code:99737-1381
Mailing Address - Country:US
Mailing Address - Phone:907-895-5444
Mailing Address - Fax:
Practice Address - Street 1:3830 S CUSHMAN ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7530
Practice Address - Country:US
Practice Address - Phone:907-452-1575
Practice Address - Fax:907-455-5287
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-22
Last Update Date:2009-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK390101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional