THE SALVATION ARMY BOOTH MEMORIAL OUTPATIENT (NPI# 1023232808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023232808 |
| Entity Type | Organization |
| Organization Name | THE SALVATION ARMY BOOTH MEMORIAL OUTPATIENT |
| Practice Address |
3600 E 20th Ave Anchorage AK 99508-3416 |
| Mailing Address |
143 E 9th Ave Anchorage AK 99501-3618 |
| Practice Telephone | 9072790522 |
| Mailing Telephone | 9073393406 |
| Mailing Fax Number | 9072762611 |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ADELENE M KELLY (DIVISIONAL FINANCE DIRECTOR) |
| Authorized Official Telephone | 9073393406 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | 11806 | AK | Behavioral Health & Social Service Providers |
| X | 104100000X | Social Worker | 11806 | AK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | DA4468 | 05 |
| Street Address |
3600 E 20TH AVE |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-3416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801418785 | Tina Demelfi-warner | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2020-05-13 |
| 1760044945 | Angel C Mcgowan | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1003478280 | Tere Lynn Turner | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1558923730 | Scott Craig Nicloy | Counselor | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2019-07-08 |
| 1902169253 | The Salvation Army | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508 | 2012-06-21 |
| 1265656730 | The Salvation Army Booth Memorial Residential Childcare | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2007-04-13 |
| 1326262890 | The Salvation Army Booth Memorial Cares for Kids Nursery | Residential Treatment Facility, Emotionally Disturbed Children | 3600 E 20th Ave, Anchorage, AK 99508-3416 | 2007-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700409471 | Evangeline Tofa Lemaota | Counselor | 4960 Est. 43rd, B3, Anchorage, AK 99508-9950 | 2020-05-28 |
| 1770091696 | Jennifer D Dolphin | Counselor | 12355 Division St, Anchorage, AK 99515-3436 | 2018-01-12 |
| 1821547647 | Reuben Pike | Counselor | 9625 Independence Drive #308, Anchorage, AK 99507-4471 | 2016-09-22 |
| 1447614185 | Tawny Nesmith | Counselor | 12741 Tanada Loop, Anchorage, AK 99515-3825 | 2016-04-08 |
| 1730565045 | Chugachmiut, Inc. | Counselor | 1840 Bragaw St, Suite 110, Anchorage, AK 99508-3401 | 2015-08-10 |
| 1851700777 | Denali Cove Counseling Center | Counselor | 1565 Bragaw St Ste 201, Anchorage, AK 99508-3101 | 2014-08-05 |
| 1437588043 | Michael Jay Horton | Counselor | 1840 Bragaw St Ste 110, Anchorage, AK 99508-3463 | 2013-11-04 |
| 1356613988 | Pamela Shepherd | Counselor | 3600 San Jeronimo Dr, Anchorage, AK 99508-2870 | 2012-01-27 |
| 1770860835 | Tamar Lubitsh | Counselor | 1320 Annapolis Dr, Anchorage, AK 99508-4310 | 2011-11-03 |
| 1902189442 | Margaret Feinstein | Counselor | 4320 Diplomacy Dr Ste 3121, Anchorage, AK 99508-5925 | 2011-09-21 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.