Individual
MEGAN IVANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHPC
Contact information
Practice address
1818 E REZANOF DR, KODIAK, AK 99615-6505
(907) 481-2400
Mailing address
PO BOX 31001-4162, PASADENA, CA 91110-4162
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/14/2025
Last updated
05/06/2026
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