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Contact Information

WENDELL STREET PSYCHIATRIC LLC
225 WENDELL ST
STE B
FAIRBANKS, AK99701-4835
 Phone: 907-455-4135
 Fax: 907-455-4115
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
 

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for WENDELL STREET PSYCHIATRIC LLC

NPI Number 1568671766
LBN Legal business name WENDELL STREET PSYCHIATRIC LLC
Authorized official MIKKI BARKER - (OWNER PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/22/2007
Last updated 08/08/2007 - About 19 years ago
Identifiers
AK License # 3921
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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