Basic Information
Provider Information
NPI: 1659919447
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RANSOM
FirstName: ESTHER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LLMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4020 FOLKER STREET
Address2:  
City: ANCHORAGE
State: AK
PostalCode: 99508
CountryCode: US
TelephoneNumber: 9075631000
FaxNumber:  
Practice Location
Address1: 1423 PEGER RD
Address2:  
City: FAIRBANKS
State: AK
PostalCode: 997095169
CountryCode: US
TelephoneNumber: 9073711300
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/12/2019
LastUpdateDate: 09/19/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/19/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  N Behavioral Health & Social Service ProvidersCounselorMental Health
104100000X6801105577MIY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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