Provider Demographics
NPI:1679710180
Name:DURTSCHI, SHIRLEY KAY (PHD, LP,C, CDCII)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:KAY
Last Name:DURTSCHI
Suffix:
Gender:F
Credentials:PHD, LP,C, CDCII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1189
Mailing Address - Street 2:273 CRYSTAL MOUNTAIN RD.
Mailing Address - City:GIRDWOOD
Mailing Address - State:AK
Mailing Address - Zip Code:99587-1189
Mailing Address - Country:US
Mailing Address - Phone:907-382-6477
Mailing Address - Fax:907-522-7088
Practice Address - Street 1:273 CRYSTAL MOUNTAIN RD.
Practice Address - Street 2:
Practice Address - City:GIRDWOOD
Practice Address - State:AK
Practice Address - Zip Code:99587-1189
Practice Address - Country:US
Practice Address - Phone:907-382-6477
Practice Address - Fax:907-729-5071
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK3003101YA0400X
AK555101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK$$$$$$$$$OtherLPC