Provider Demographics
NPI:1508481144
Name:LOOKING FORWARD PSYCHIATRY AND COUNSELING LLC
Entity Type:Organization
Organization Name:LOOKING FORWARD PSYCHIATRY AND COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MRZENA
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:907-203-1590
Mailing Address - Street 1:290 N WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7042
Mailing Address - Country:US
Mailing Address - Phone:907-203-1590
Mailing Address - Fax:
Practice Address - Street 1:290 N WILLOW ST
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7042
Practice Address - Country:US
Practice Address - Phone:907-203-1590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-09
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health