Organization
MONARCH PSYCHIATRY OF ALASKA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUCINDA MILLER-MANGROBANG (MEMBER MANAGER)
(907) 885-1089
Entity
Organization
Contact information
Practice address
101 W BENSON BLVD STE 306, ANCHORAGE, AK 99503-3936
(907) 885-1089
(907) 885-1059
Mailing address
101 W BENSON BLVD STE 306, ANCHORAGE, AK 99503-3936
(907) 885-1089
(907) 885-1059
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
576
AK
2084P0800X
Psychiatry Physician
4965
AK
261QM0850X
Adult Mental Health Clinic/Center
Primary
1062801
AK
261QM0855X
Adolescent and Children Mental Health Clinic/Center
1062801
AK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1364
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679481
—
AK
01
—
615323
TRICARE HNFS GROUP NUMBER
AK
Enumeration date
12/12/2017
Last updated
01/16/2023
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