| Name: | Megan Russell-Licata, LPC, LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 28 Jul 2016 (9 years ago) |
| Entity Number: | 10040304 |
| ZIP code: | 99508 |
| County: | Anchorage |
| Place of Formation: | ALASKA |
| Address: | 2401 E 42ND AVE STE 306, ANCHORAGE, AK 99508 |
| Mailing Address: | 1617 LOGAN ST, ANCHORAGE, AK 99508 |
Line of Business
62 Health Care and Social AssistanceNAICS
621330 OFFICES OF MENTAL HEALTH PRACTITIONERS (EXCEPT PHYSICIANS)| Name | Role |
|---|---|
| Megan Russell-Licata | Member |
| Megan Russell-Licata | Registered Agent |
| License Number | Type | Status | Issue Date | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| 1040558 | Business License | Active | 2016-08-01 | 2023-11-06 | 2025-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621330 - OFFICES OF MENTAL HEALTH PRACTITIONERS (EXCEPT PHYSICIANS) |
| License Number | Program | Type | Status | Issue Date | Effective Date | Expiration Date |
|---|---|---|---|---|---|---|
| 159125 | Telemedicine Business Registry | Telemedicine Business Registry | Active | 2020-03-19 | 2020-03-19 | - |
Date of last update: 05 Feb 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
