Provider Demographics
NPI:1689843161
Name:FONG, AARON CHRISTOPHER (MA, RC)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:CHRISTOPHER
Last Name:FONG
Suffix:
Gender:
Credentials:MA, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 33086
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99803-3086
Mailing Address - Country:US
Mailing Address - Phone:907-401-1589
Mailing Address - Fax:
Practice Address - Street 1:3051 VINTAGE PARK BLVD
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-463-0160
Practice Address - Fax:907-463-0161
Is Sole Proprietor?:No
Enumeration Date:2008-02-28
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00053968101YM0800X
WACG60137795101YM0800X
171M00000X
AK146154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00053968OtherREGISTERED COUNSELOR
WACG60137795OtherAGENCY AFFILIATED COUNSELOR