Provider Demographics
NPI:1013660620
Name:SPRING COUNSELING LLC
Entity type:Organization
Organization Name:SPRING COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:WADDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-250-6608
Mailing Address - Street 1:PO BOX 141823
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99514-1823
Mailing Address - Country:US
Mailing Address - Phone:907-250-6608
Mailing Address - Fax:907-917-5443
Practice Address - Street 1:4050 LAKE OTIS PKWY STE 201A
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5221
Practice Address - Country:US
Practice Address - Phone:907-250-6608
Practice Address - Fax:907-917-5443
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DIANA WADDELL LCSW
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)