Organization
FLT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY LEWIS LCSW (MANAGING MEMBER)
(907) 457-1128
Entity
Organization
Contact information
Practice address
250 CUSHMAN ST STE 4F, FAIRBANKS, AK 99701-4665
(907) 457-1128
(907) 457-1124
Mailing address
PO BOX 80361, FAIRBANKS, AK 99708-0361
(907) 457-1128
(907) 457-1124
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1025780
AK
Other
Enumeration date
09/17/2015
Last updated
03/04/2016
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