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CORNELIUS LEE MINGO JR.
NPI 1134711708
Counselor - Addiction (Substance Use Disorder) in Fairbanks, AK

Active since February 05, 2021
542 4TH AVE STE B101, FAIRBANKS, AK 99701(907) 374-1097 Get Directions Write a Review

NPPES record last updated: February 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Cornelius Lee Mingo Jr. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CORNELIUS LEE MINGO JR. (NPI 1134711708) is an individual addiction (substance use disorder) provider in Fairbanks, Alaska and active in the NPI registry since February 2021.

NPPES Registry Identity

NPI1134711708
Entity TypeIndividualMale
Primary Taxonomy101YA0400X
Provider Legal NameCORNELIUS LEE MINGO JR.
Location Address542 4TH AVE STE B101Fairbanks, AK 99701-4707
Mailing AddressPo Box 73004Fairbanks, AK 99707-3004
Phone(907) 374-1097
Sole ProprietorNo
Enumeration DateFebruary 5, 2021
NPPES CertifiedFebruary 5, 2021
✔ NPI 1134711708 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
542 4TH AVE STE B101, Fairbanks, AK 99701
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Other Identifiers 1

Medicaid1687081AK

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TERRA DUNKLEY
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
JEWEL PRESHAW
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
ALICIA DESMOND
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
MONIQUE LEYVA
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
SHAWNA R KEITH
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
MELINDA S PRIDE
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
HAILEY JENKINS
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097
SHAUNA MURSCH
Counselor (Addiction (Substance Use Disorder))
542 4TH AVE STE B101
FAIRBANKS, AK 99701
Fairbanks North Star Borough (907) 374-1097

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cornelius Mingo's NPI number?

The NPI number for Cornelius Mingo is 1134711708. It was assigned to this individual provider in the NPPES registry on February 5, 2021.

Where is Cornelius Mingo located?

Cornelius Mingo practices at 542 4th Ave Ste B101, Fairbanks, AK 99701. The listed phone number is (907) 374-1097.

What is Cornelius Mingo's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Cornelius Mingo was last updated on February 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.