Individual
ERIC BRINTON FARNSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 N. WILLOW ST., WASILLA, AK 99654
(907) 373-4357
Mailing address
300 N. WILLOW ST., WASILLA, AK 99654
(907) 373-4357
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1735570
—
AK
Enumeration date
12/15/2022
Last updated
04/09/2026
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