Provider Demographics
NPI:1942628532
Name:CARPENTER, DOUGLAS G (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:G
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 E INTL AIRPORT RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99518-1409
Mailing Address - Country:US
Mailing Address - Phone:907-570-6382
Mailing Address - Fax:888-972-3679
Practice Address - Street 1:1205 E INTL AIRPORT RD
Practice Address - Street 2:SUITE 103
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99518-1409
Practice Address - Country:US
Practice Address - Phone:907-570-6382
Practice Address - Fax:800-972-3679
Is Sole Proprietor?:No
Enumeration Date:2014-04-01
Last Update Date:2019-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK107777103TC1900X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling