Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Kathleen Ketzler Demientieff, TC, CDC1

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1215187505

Mrs. Kathleen Ketzler Demientieff, TC, CDC1 is an Addiction (Substance Use Disorder) Counselor in Fairbanks, Alaska. Practices as a sole proprietor. Licensed in Alaska.

Licensed in
AK
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

1027 Evergreen St
Fairbanks, AK 99709-4306
Phone: (907) 451-8164
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 2920 (AK)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 3432 (AK)

Record details

NPI number1215187505
Entity typeIndividual (Type 1)
GenderFemale
Credentials TC , CDC1
Sole proprietorYes
NPI enumeratedSeptember 24, 2008
Last updated in NPPESSeptember 24, 2008

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