PROVIDENCE KODIAK ISLAND COUNSELING CENTER (NPI# 1093147589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093147589 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE KODIAK ISLAND COUNSELING CENTER |
| Practice Address |
717 E Rezanof Dr Kodiak AK 99615-6416 |
| Practice Telephone | 9074812400 |
| Practice Fax Number | 9074812419 |
| Mailing Telephone | 9074812400 |
| Mailing Fax Number | 9074812419 |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2013-08-06 |
| Authorized Official Name | MRS. VERONICA SAMANIEGO (CASE MNANAGER) |
| Authorized Official Telephone | 9074812400 |
| Authorized Official Credential | BA |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HEALTH AND SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251B00000X | Case Management | 920162237 | AK | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141929 | Providence Kodiak Island Counseling Center | Community/Behavioral Health | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2020-10-15 |
| Street Address |
717 E REZANOF DR |
| City | KODIAK |
| State | AK |
| Zip Code | 99615-6416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477563344 | Providence Health & Services Washington | Psychiatry & Neurology | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2006-08-09 |
| 1376141929 | Providence Kodiak Island Counseling Center | Community/Behavioral Health | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2020-10-15 |
| 1467079442 | Alexandra S Woodside | Counselor | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2020-06-25 |
| 1295365732 | Kimberly Katelnikoff | Case Manager/Care Coordinator | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2020-01-23 |
| 1518507029 | Starr Shanley | Case Manager/Care Coordinator | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2020-01-13 |
| 1265915193 | Christine L Foster | Counselor | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2018-09-06 |
| 1285115832 | Laura Lynette Griffin | Case Manager/Care Coordinator | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2018-08-22 |
| 1679053391 | Cynthia Clogston | Case Manager/Care Coordinator | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2018-08-21 |
| 1104310200 | Stephanie M Mccarter | Counselor | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2018-06-21 |
| 1124545991 | Maria Theresa Vitor Cabrera | Registered Nurse | 717 E Rezanof Dr, Kodiak, AK 99615-6416 | 2017-08-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864232 | Linda Irene Dunlap | Spec/Tech, Pathology | 1915 E. Remanof Drive, Kodiak, AK 99615 | 2019-10-31 |
| 1639638190 | Stephanie Brenteson | Community Health Worker | 125 Airport Way, Akhiok, AK 99615 | 2019-03-14 |
| 1609351022 | Desiree Alexis Wheeler | Optometrist | 3450 E Rezanof Dr, Kodiak, AK 99615 | 2018-10-02 |
| 1417479072 | Elaine Loomis Olsen | Case Manager/Care Coordinator | 1111 Purtov St., Kodiak, AK 99615 | 2017-07-14 |
| 1750828414 | Mary Jean Francisco | Case Manager/Care Coordinator | 717 East Rezanof Drive, Kodiak, AK 99615 | 2017-01-19 |
| 1558818112 | Carolyn Hawes | Case Manager/Care Coordinator | 717 Rezanof Dr, Kodiak, AK 99615 | 2016-09-01 |
| 1285083683 | Amanda Wilson | Community Health Worker | 124 Akhiok Street, Akhiok, AK 99615 | 2016-06-07 |
| 1447612056 | Kailee Champion | Massage Therapist | 3449 Rezanof Drive East, Kodiak, AK 99615 | 2016-03-23 |
| 1376891069 | Krystyna Mcrobert | Technician, Other | Cape Sarichef Road Bldg N46, Rockmore King Clinic, Kodiak, AK 99615 | 2012-08-28 |
| 1164778619 | Mark Anthony Johnson | Pharmacist | 3449 Rezanof Drive, Kodiak, AK 99615 | 2012-08-01 |
| Find all providers in zip 99615 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518191121 | Community Inclusion Services | Case Management | 914 Steller Way, Kodiak, AK 99615-6490 | 2009-05-11 |
| 1841652393 | Swanberg Human Services, LLC | Case Management | 326 Center Ave, Suite 209, Kodiak, AK 99615-7302 | 2016-03-23 |
| 1174948665 | Kodiak Area Native Association | Case Management | 3449 Rezanof Dr E, Kodiak, AK 99615-6952 | 2014-02-20 |
| 1336364710 | Hope Community Resources Inc | Case Management | 1623 Mill Bay Rd, Kodiak, AK 99615-6235 | 2007-04-13 |
| 1164552204 | Hope Community Resources Inc | Case Management | 1623 Mill Bay Rd, Kodiak, AK 99615-6235 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851915953 | Sundance Ak Care Coordination LLC | Case Management | 11830 Northern Raven Dr, Anchorage, AK 99516-1978 | 2020-06-04 |
| 1891331237 | Daybreak Incorporated | Case Management | 121 W Fireweed Ln Ste 175, Anchorage, AK 99503-2035 | 2019-11-20 |
| 1619519055 | Person Centered Care Corrdination, Inc. | Case Management | 4911 S Albert Cir, Wasilla, AK 99623-9864 | 2019-10-16 |
| 1841855459 | Care Solutions & Coordination, LLC | Case Management | 1805 Miranda Ct, Kenai, AK 99611-6658 | 2019-05-08 |
| 1063975936 | Lisa Rochon-martin | Case Management | 2820 Watergate Way Apt 4, Kenai, AK 99611-8861 | 2019-04-09 |
| 1902370042 | Alpenglow Care Coordination LLC | Case Management | 3310 Lois Dr, Anchorage, AK 99517-2036 | 2019-01-11 |
| 1679055503 | Compassionate Care Coordination & Planning LLC | Case Management | 49855 Bishop Dr # 3, Kenai, AK 99611-9439 | 2018-09-06 |
| 1053893248 | Kristine Joie M Mendoza | Case Management | 2483 Lochenshire Pl, Anchorage, AK 99504-5900 | 2018-09-04 |
| 1952895336 | Ak Waiver and Tefra Planning LLC | Case Management | 14041 Sunview Dr, Anchorage, AK 99515-4131 | 2018-06-19 |
| 1437643301 | 1by Grace Tefra Services, LLC | Case Management | 6644 Cimarron Cir, Anchorage, AK 99504-3945 | 2018-06-14 |
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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.