Provider Demographics
NPI:1699276436
Name:SAGERS, RONDA LYNN (LPC)
Entity type:Individual
Prefix:
First Name:RONDA
Middle Name:LYNN
Last Name:SAGERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1848 OTTER SLIDE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-2700
Mailing Address - Country:US
Mailing Address - Phone:307-399-3617
Mailing Address - Fax:
Practice Address - Street 1:1848 OTTER SLIDE LN
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-2700
Practice Address - Country:US
Practice Address - Phone:307-399-3617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-27
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK178939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional