Basic Information
| Provider Information | |||||||||
| NPI: | 1346444312 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINKE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | GERALD | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | CDC II, NCAC I | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5211 MOCKINGBIRD DR APT 106 | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995071686 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073157046 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 121 W FIREWEED LN STE 105 | ||||||||
| Address2: | |||||||||
| City: | ANCHORAGE | ||||||||
| State: | AK | ||||||||
| PostalCode: | 995032044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9078659653 | ||||||||
| FaxNumber: | 9078659124 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2007 | ||||||||
| LastUpdateDate: | 12/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CERTIFICATE 2261 | AK | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
ID Information
| ID | Type | State | Issuer | Description | DA4437 | 05 | AK | MEDICAID |