Organization
HEADWATERS WELLNESS AND COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIZ PAWELKO LPC (OWNER)
(907) 456-2256
Entity
Organization
Contact information
Practice address
250 CUSHMAN ST, SUITE 4J, FAIRBANKS, AK 99701-4665
(907) 456-2256
(907) 456-2260
Mailing address
250 CUSHMAN ST STE 5, FAIRBANKS, AK 99701-4665
(907) 456-2256
(907) 456-2260
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PCOC613
AK
261QM0850X
Adult Mental Health Clinic/Center
—
—
Other
Enumeration date
11/28/2016
Last updated
12/11/2017
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