Provider Demographics
NPI:1366765513
Name:THALLER, PYPER MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:PYPER
Middle Name:MARIE
Last Name:THALLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:PYPER
Other - Middle Name:MARIE
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 1094
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:WA
Mailing Address - Zip Code:98631
Mailing Address - Country:US
Mailing Address - Phone:360-214-2125
Mailing Address - Fax:
Practice Address - Street 1:3470 TONGASS BLVD.
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:360-214-2155
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60209887101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health