Provider Demographics
NPI:1972906089
Name:BORDER, CARRIE ELAINE I (MED, LPC-S)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:ELAINE
Last Name:BORDER
Suffix:I
Gender:F
Credentials:MED, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 W 36TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5853
Mailing Address - Country:US
Mailing Address - Phone:907-903-7123
Mailing Address - Fax:855-952-3836
Practice Address - Street 1:471 W 36TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5853
Practice Address - Country:US
Practice Address - Phone:907-903-7123
Practice Address - Fax:855-952-3836
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK118148101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional