Individual
MR. JASON BRENT FEDELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LPC-S
Contact information
Practice address
9330 VANGUARD DR STE 202, ANCHORAGE, AK 99507-5393
(907) 202-2527
Mailing address
9330 VANGUARD DR STE 202, ANCHORAGE, AK 99507-5393
(907) 202-2527
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
119538
AK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013676055
NPI-2
AK
01
—
119538
STATE OF ALASKA LPC LICENSE
AK
01
—
2093603
ALASKA BUSINESS LICENSE
AK
Enumeration date
04/05/2013
Last updated
12/23/2024
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