Provider Demographics
NPI:1639981814
Name:MOUNT MAGNIFICENT WELLNESS AND COUNSELING, LLC
Entity type:Organization
Organization Name:MOUNT MAGNIFICENT WELLNESS AND COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUFF
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:907-242-3203
Mailing Address - Street 1:19340 MOUNT MAGNIFICENT CIR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9775
Mailing Address - Country:US
Mailing Address - Phone:907-242-3203
Mailing Address - Fax:
Practice Address - Street 1:11517 OLD GLENN HWY
Practice Address - Street 2:
Practice Address - City:EAGLE RIVER
Practice Address - State:AK
Practice Address - Zip Code:99577-7325
Practice Address - Country:US
Practice Address - Phone:907-242-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)