Basic Information
| Provider Information | |||||||||
| NPI: | 1003367822 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTHY PSYCHOLOGICAL FUTURES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34881 | ||||||||
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| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998034881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077239828 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9000 GLACIER HWY | ||||||||
| Address2: | |||||||||
| City: | JUNEAU | ||||||||
| State: | AK | ||||||||
| PostalCode: | 998018032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9077239828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2016 | ||||||||
| LastUpdateDate: | 10/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | SARGEANT | ||||||||
| AuthorizedOfficialFirstName: | DESTINY | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINICAL PSYCHOLOGIST | ||||||||
| AuthorizedOfficialTelephone: | 9077239828 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | PHD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | PSYP348 | AK | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.