| Greatland Mental Health, Llc | |
|
1407 W 31st Ave Ste 201 Anchorage AK 99503-3678 | |
| (907) 929-4009 | |
| (907) 929-4902 |
| Full Name | Greatland Mental Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1407 W 31st Ave, Anchorage, Alaska |
| Authorized Official Name and Position | Theresa M Ronco (BILLING MANAGER) |
| Authorized Official Contact | 9076327577 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greatland Mental Health, Llc Po Box 111810 Anchorage AK 99511-1810 Ph: (907) 929-4009 | Greatland Mental Health, Llc 1407 W 31st Ave Ste 201 Anchorage AK 99503-3678 Ph: (907) 929-4009 |
| NPI Number | 1477743532 |
|---|---|
| Provider Enumeration Date | 07/25/2007 |
| Last Update Date | 07/25/2007 |
| Medicare PECOS PAC ID | 4385794437 |
|---|---|
| Medicare Enrollment ID | O20090610000615 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477743532 | NPI | - | NPPES |
| MH3538 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Christina R Haskell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932291929 PECOS PAC ID: 9830123314 Enrollment ID: I20050923000459 |
| Provider Name | Eric Garby |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891826400 PECOS PAC ID: 9537194287 Enrollment ID: I20050930000308 |
| Provider Name | Aryeh L Levenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245303650 PECOS PAC ID: 7214944461 Enrollment ID: I20060313000359 |
| Provider Name | Connie L Chevalier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316992191 PECOS PAC ID: 1850302100 Enrollment ID: I20060526000091 |
| Provider Name | Royal P Kiehl |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144292533 PECOS PAC ID: 9931201126 Enrollment ID: I20070219000226 |
| Provider Name | Ronald A Feigin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568435113 PECOS PAC ID: 5890899926 Enrollment ID: I20070330000022 |
| Provider Name | Judith C Dean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548283096 PECOS PAC ID: 6709936669 Enrollment ID: I20090615000600 |
| Provider Name | Rick A Graber |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700814134 PECOS PAC ID: 0244376721 Enrollment ID: I20091014000465 |
| Provider Name | Masao Yanagida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467431601 PECOS PAC ID: 5890609762 Enrollment ID: I20111108000576 |
| Provider Name | Ann Yates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386913796 PECOS PAC ID: 6901066349 Enrollment ID: I20120322000374 |
| Provider Name | Janine P Stitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265666366 PECOS PAC ID: 6406981976 Enrollment ID: I20140710002589 |
| Provider Name | Donna Westlake |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306811484 PECOS PAC ID: 7315974136 Enrollment ID: I20140806002211 |
| Provider Name | Michael L Blakey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396953691 PECOS PAC ID: 0749561439 Enrollment ID: I20170112000595 |
| Provider Name | Sara L Kozup-evon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164919411 PECOS PAC ID: 2769746973 Enrollment ID: I20180515002215 |
| Provider Name | Sarah T Mccutcheon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609070374 PECOS PAC ID: 6901031038 Enrollment ID: I20181204003895 |
| Provider Name | Sara Rottman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760017123 PECOS PAC ID: 3870975972 Enrollment ID: I20220805002686 |
| Provider Name | Lara Amalia Collis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194055400 PECOS PAC ID: 7315382249 Enrollment ID: I20240229003763 |
| Provider Name | Allison A Koos Fox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124335377 PECOS PAC ID: 1355786245 Enrollment ID: I20240301001293 |
| Provider Name | Shawnalea D Fox |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932712577 PECOS PAC ID: 2769828730 Enrollment ID: I20240313000352 |
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