Basic Information
| Provider Information | |||||||||
| NPI: | 1114295730 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FIELD | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | SOPHIA | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 256 | ||||||||
| Address2: | |||||||||
| City: | KOTZEBUE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997520256 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9074427640 | ||||||||
| FaxNumber: | 9074427749 | ||||||||
| Practice Location | |||||||||
| Address1: | 1897 TUNDRA WAY | ||||||||
| Address2: | BOX 189 | ||||||||
| City: | NOORVIK | ||||||||
| State: | AK | ||||||||
| PostalCode: | 997630189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9076362103 | ||||||||
| FaxNumber: | 9076362195 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/09/2011 | ||||||||
| LastUpdateDate: | 02/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 172V00000X | 10-1058-III | AK | N | Other Service Providers | Community Health Worker | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.