GINA THARA WALL (NPI# 1073121752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073121752 |
| Entity Type | Individual |
| Full Name | GINA THARA WALL |
| Credential | LPC |
| Practice Address |
17601 James Way Eagle River AK 99577-9254 |
| Practice Telephone | 9078542344 |
| Mailing Telephone | 9078542344 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
159747 | AK | Behavioral Health & Social Service Providers |
| Street Address |
17601 JAMES WAY |
| City | EAGLE RIVER |
| State | AK |
| Zip Code | 99577-9254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831758333 | Dianne E Lyons | Behavior Technician | 16331 Heritage Place, Suite 101, Eagle River, AK 99577 | 2019-06-07 |
| 1073007209 | Center for Natural Medicine, Inc. | Acupuncturist | 16844 Easy St, Eagle River, AK 99577 | 2018-06-20 |
| 1538652748 | Shelly Rana Budde | Nurse Practitioner | 19139 Upper Skyline Dr, Eagle River, AK 99577 | 2018-06-12 |
| 1700387529 | Aaron Wesley Jones | Behavior Technician | 16941 Notrh Eagle River Loop Road, Eagle River, Ak, AK 99577 | 2018-02-27 |
| 1033641881 | Sierra Bracken | Massage Therapist | 12812 Old Glenn Hwy, Ste C3, Eagle River, AK 99577 | 2017-03-31 |
| 1699213231 | Jolene Denee Rogers | Counselor | 13620 Old Glenn Hwy, Ste C, Eagle River, AK 99577 | 2017-02-02 |
| 1881040962 | Elizabeth Hanson | Behavioral Analyst | 16941 North Eagle River Loop Road, Suite 3, Eagle River, AK 99577 | 2016-05-09 |
| 1023496148 | Joel Richard Wallace | Dentist | 16727 Farm Avenue, Eagle River, AK 99577 | 2015-05-08 |
| 1184019663 | Nicole Christine Newman | Physician Assistant | 11432 Business Blvd., Suite 4, Eagle River, AK 99577 | 2015-04-01 |
| 1417365362 | Tammi Smith | Community Health Worker | 16510 Centerfield Dr B 107, Eagle River, AK 99577 | 2014-07-23 |
| Find all providers in zip 99577 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947893 | Jo Flesner | Counselor | 17101 Snowmobile Ln Ste 109, Eagle River, AK 99577-7043 | 2020-06-18 |
| 1316587173 | Janet Daw | Counselor | 10714 Colville St, Eagle River, AK 99577-8287 | 2020-01-09 |
| 1730540709 | Kaylen Kelley | Counselor | 12421 Lake St Apt 6, Eagle River, AK 99577-6903 | 2016-03-17 |
| 1649649997 | Paul Baysinger | Counselor | 11723 Old Glenn Hwy Ste 203, Eagle River, AK 99577-7750 | 2015-09-16 |
| 1437554243 | Daniel Pinkerton | Counselor | 16123 Artillery Rd, Eagle River, AK 99577-8076 | 2014-10-23 |
| 1295007078 | Alpenglow Counseling, LLC | Counselor | 16600 Centerfield Dr, Suite 201, Eagle River, AK 99577-7718 | 2012-02-08 |
| 1437313160 | Deborah A Spira | Counselor | 17101 Snowmobile Lane, Suite 109, Eagle River, AK 99577 | 2008-07-11 |
| 1306221544 | Aurora Sidney-ando | Counselor | 17025 Snowmobile Ln, Suite 4, Eagle River, AK 99577-7044 | 2015-07-29 |
| 1164817169 | Desiree Niederer | Counselor | 17105 Park Place St, Eagle River, AK 99577-7821 | 2015-04-06 |
| 1588064943 | Kristi Seymour | Counselor | 11723 Old Glenn Hwy, Suite 205, Eagle River, AK 99577-7044 | 2014-09-03 |
| Find all providers in EAGLE RIVER | ||||
| City | EAGLE RIVER |
| Zip Code | 99577 |
Please comment or provide details below to improve the information on GINA THARA WALL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.