Provider Demographics
NPI:1265725923
Name:ERIC UNRUH COUNSELING, LLC
Entity type:Organization
Organization Name:ERIC UNRUH COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:UNRUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-240-9369
Mailing Address - Street 1:11940 BUSINESS BLVD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-7724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11940 BUSINESS BLVD
Practice Address - Street 2:SUITE 207
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7724
Practice Address - Country:US
Practice Address - Phone:907-240-9369
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK6471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty