Organization
COMMUNITY COUNSELING & CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREMLATA NIKONIUK LPC, LCPC, NCC (MANAGING MEMBER)
(907) 631-3606
Entity
Organization
Contact information
Practice address
300 W GRAYBARK DR, UNIT B, WASILLA, AK 99654-6382
(907) 631-3606
Mailing address
300 W GRAYBARK DR, UNIT B, WASILLA, AK 99654-6382
(907) 631-3606
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
691
AK
Other
Enumeration date
04/07/2011
Last updated
04/13/2011
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