Provider Demographics
NPI:1497946081
Name:LANDERS, LORRAINE (LPC)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:LANDERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:626 2ND ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-3466
Mailing Address - Country:US
Mailing Address - Phone:907-687-2737
Mailing Address - Fax:907-347-1887
Practice Address - Street 1:626 2ND ST
Practice Address - Street 2:SUITE 303
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-3466
Practice Address - Country:US
Practice Address - Phone:907-687-2737
Practice Address - Fax:907-347-1887
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional