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Wild Goose Counseling Llc
Adolescent and Children Mental Health Clinic/Center in Soldotna, Alaska
NPI 1891224879

Wild Goose Counseling Llc is an Adolescent and Children Mental Health Clinic/Center based in Soldotna, AK and is specialized in Adolescent and Children Mental Health. Wild Goose Counseling Llc practices in Soldotna, AK. The NPI Number for Wild Goose Counseling Llc is 1891224879 and holds a License No. (Alaska).

The current practice location address for Wild Goose Counseling Llc is 198 W Marydale Ave, Soldotna, AK and can be reached out via phone at 907-953-9614. You can also correspond with Wild Goose Counseling Llc through the mailing address at 379 W KATMAI AVE, SOLDOTNA, AK - 99669-7315 (mailing address contact number: 907-953-9614).

Location: 198 W Marydale Ave, Soldotna, AK, 99669-7315
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1891224879
Provider Name
Wild Goose Counseling Llc
Credential
Provider Entity Type
Organization
Address
198 W Marydale Ave, Soldotna, AK, 99669-7315
Phone Number
907-953-9614
Fax Number
Provider Enumeration Date
06/05/2017
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
109623 01 AK LICENSED PROFESSIONAL COUNSELOR MOLLY DAVIS
109622 01 AK LICENSED PROFESSIONAL COUNSELOR LYDIA DAVIS
institution
Provider Business Practice Location Address Details
Address
198 W Marydale Ave
City
Soldotna
State
Alaska
Zip
99669-7501
Phone Number
907-953-9614
Fax Number
person
Provider Business Mailing Address Details
Address
379 W Katmai Ave
City
Soldotna
State
Alaska
Zip
99669-7315
Phone Number
907-953-9614
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
261QM0801X
License No.
(Alaska)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
(Alaska)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
person
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adolescent and Children Mental Health
Taxonomy
261QM0855X
License No.
(Alaska)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
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