Provider Demographics
NPI:1265036990
Name:FIDDLEHEAD FAMILY COUNSELING LLC
Entity type:Organization
Organization Name:FIDDLEHEAD FAMILY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HORN-ROLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:907-318-9197
Mailing Address - Street 1:7333 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99502-3074
Mailing Address - Country:US
Mailing Address - Phone:907-538-9591
Mailing Address - Fax:
Practice Address - Street 1:431 W 7TH AVE STE 206
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3500
Practice Address - Country:US
Practice Address - Phone:907-318-9197
Practice Address - Fax:907-318-9198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health