SCOTT ALEN KOTULAK (NPI# 1114571858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114571858 |
| Entity Type | Individual |
| Full Name | SCOTT ALEN KOTULAK |
| Credential | BA IN PSYCHOLOGY |
| Practice Address |
1650 Bragaw St Anchorage AK 99508-3435 |
| Mailing Address |
11351 Discovery View Dr Apt 102a Anchorage AK 99515-2753 |
| Practice Telephone | 9072587575 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-07-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
1650 BRAGAW ST |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-3435 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841364957 | Frontlline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2006-11-20 |
| 1851938328 | Frontline Hospital LLC | Community/Behavioral Health | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-12-04 |
| 1669027884 | Robert Oconnor | Counselor | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-08-05 |
| 1235784786 | Wesley Ann Rivera | Registered Nurse | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-08-01 |
| 1952956427 | Jon Droska | Registered Nurse | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-08-01 |
| 1508411075 | Bryan Brandenburg | Counselor | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-08-01 |
| 1972157477 | Jannette M Johnson | Behavior Technician | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-08-01 |
| 1598319295 | Tracie Robertson | Registered Nurse | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-07-31 |
| 1376197061 | Carmen Botros Rizkalla | Registered Nurse | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-07-31 |
| 1184278897 | Dallas Alberthal | Registered Nurse | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2019-07-31 |
| Find all providers in the same location | ||||
| 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 | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002113 | Volunteers of America Alaska, Central Ms | Clinic/Center | 1405 E St, Anchorage, AK 99501-5047 | 2020-10-27 |
| 1811597065 | Volunteers of America Alaska, West Hs | Clinic/Center | 1700 Hillcrest Dr, Anchorage, AK 99517-1347 | 2020-10-27 |
| 1578163721 | Volunteers of America Alaska, Romig Ms | Clinic/Center | 2500 Minnesota Dr, Anchorage, AK 99503-2384 | 2020-10-27 |
| 1295335446 | Volunteers of America Alaska, Tyson Es | Clinic/Center | 2801 Richmond Ave, Anchorage, AK 99508-1099 | 2020-10-27 |
| 1063033959 | Volunteers of America Alaska, Bartlett Hs | Clinic/Center | 1101 Golden Bear Dr, Anchorage, AK 99504-6120 | 2020-05-01 |
| 1427679307 | Volunteers of America Alaska, Benny Ss | Clinic/Center | 4515 Campbell Airstrip Rd, Anchorage, AK 99507-1267 | 2020-05-01 |
| 1396366290 | Volunteers of America Alaska, East Hs | Clinic/Center | 4025 E Northern Lights Blvd, Anchorage, AK 99508-3588 | 2020-05-01 |
| 1720548035 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 | 2019-03-22 |
| 1750854089 | Southcentral Foundation | Clinic/Center | 400 W Benson Blvd, Anchorage, AK 99503-3829 | 2019-01-09 |
| 1376056952 | Integrated Wellness and Recovery | Clinic/Center | 3820 Lake Otis Pkwy Ste 112, Anchorage, AK 99508 | 2017-11-06 |
| 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.