Provider Demographics
NPI:1003675067
Name:SEALING COVE COUNSELING
Entity type:Organization
Organization Name:SEALING COVE COUNSELING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHESSED
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:907-738-9088
Mailing Address - Street 1:7002 NAPLES WAY
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-8701
Mailing Address - Country:US
Mailing Address - Phone:907-738-9088
Mailing Address - Fax:
Practice Address - Street 1:821 N ST STE 102
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3285
Practice Address - Country:US
Practice Address - Phone:907-312-5564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty