| Providence Kodiak Island Counseling Center | |
|
717 E Rezanof Dr Kodiak AK 99615-6416 | |
| (907) 481-2400 | |
| (907) 481-2419 |
| Full Name | Providence Kodiak Island Counseling Center |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 717 E Rezanof Dr, Kodiak, Alaska |
| Authorized Official Name and Position | Donald W Anderson (ASST SEC FOR ENROLLENT/DIR REIMB) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Kodiak Island Counseling Center Po Box 3290 Portland OR 97208-3290 Ph: (907) 481-2000 | Providence Kodiak Island Counseling Center 717 E Rezanof Dr Kodiak AK 99615-6416 Ph: (907) 481-2400 |
| NPI Number | 1376141929 |
|---|---|
| Provider Enumeration Date | 10/15/2020 |
| Last Update Date | 10/15/2020 |
| Certification Date | 10/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376141929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Mcnerney Enterprises Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1944 E Rezanof Dr, Kodiak, AK 99615 Phone: 907-942-1986 | |
Foreman Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1944 E Rezanof Dr, Kodiak, AK 99615 Phone: 907-654-9653 | |
Providence Kodiak Island Counseling Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1818 E Rezanof Dr, Kodiak, AK 99615 Phone: 907-481-2400 Fax: 907-481-2419 | |
Ken Mccarty, Lmft Discovery Cove Recovery & Wellness Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2975 Mill Bay Rd., Suite B, Kodiak, AK 99615 Phone: 907-487-2223 Fax: 907-487-2229 |