Provider Demographics
NPI:1902112592
Name:CHUA-HACKETT, BRIGID SY (LPC)
Entity type:Individual
Prefix:MRS
First Name:BRIGID
Middle Name:SY
Last Name:CHUA-HACKETT
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MRS
Other - First Name:BRIGID
Other - Middle Name:SY
Other - Last Name:CHUA-HACKETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:601 N BUNKER HILL ST STE E
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6790
Mailing Address - Country:US
Mailing Address - Phone:907-317-6168
Mailing Address - Fax:907-357-7343
Practice Address - Street 1:601 N BUNKER HILL ST STE E
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6790
Practice Address - Country:US
Practice Address - Phone:907-317-6168
Practice Address - Fax:907-357-7343
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
AK660101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)