TIMOTHY GILLIS (NPI# 1154639763) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154639763 |
| Entity Type | Individual |
| Full Name | TIMOTHY GILLIS |
| Credential | LPC, LPCS, MAC, CDCI |
| Practice Address |
110 N Willow St Kenai AK 99611-7701 |
| Mailing Address |
Po Box 1692 Kenai AK 99611-1692 |
| Practice Telephone | 9073980524 |
| Practice Fax Number | 8886782961 |
| Mailing Telephone | 9073980524 |
| Mailing Fax Number | 8886782961 |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2017-01-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
508906 | AK | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
624 | AK | Behavioral Health & Social Service Providers |
| Street Address |
110 N WILLOW ST |
| City | KENAI |
| State | AK |
| Zip Code | 99611-7701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134131048 | Michael J Wolfe | Social Worker | 110 N Willow St, Kenai, AK 99611-7701 | 2006-08-12 |
| 1699986687 | Kenaitze Indian Tribe | Community/Behavioral Health | 110 N Willow St, Kenai, AK 99611-7701 | 2007-05-24 |
| 1023229010 | Kenaitze Indian Tribe | Clinic/Center | 110 N Willow St, Kenai, AK 99611-7701 | 2007-05-24 |
| 1457491409 | Kenaitze Indian Tribe | Counselor | 110 N Willow St, Kenai, AK 99611-7701 | 2007-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649803099 | Guardian Flight LLC | Ambulance | 145 Granite Point Ct, Kenai, AK 99611 | 2020-02-13 |
| 1104482967 | James Daniel Hudson | Massage Therapist | 601 Frontage Rd Suite 103, Kenai, AK 99611 | 2019-05-16 |
| 1255996351 | Shelly Lynn Niblack | Counselor | 10200, Kenai Sour Hwy, Kenai, AK 99611 | 2019-05-03 |
| 1780142042 | Odyssey Family Practice LLC | Clinic/Center | 11595 Kenai Spur Highway, Kenai, AK 99611 | 2019-03-06 |
| 1043793656 | Jerri Ann Chivers | Massage Therapist | 10815 Kenai Spur Highway, Kenai, AK 99611 | 2018-09-10 |
| 1003320060 | Christine G. Morin | Massage Therapist | 1608 Tanga Circle, Kenai, AK 99611 | 2017-11-28 |
| 1013433259 | Amanda Mckinley | Registered Nurse | 630 Barnacle Way Suite A, Kenai, AK 99611 | 2017-08-18 |
| 1780132753 | Kenai Peninsula Imaging Center LLC | Clinic/Center | 100 Trading Bay Rd Ste 7, Kenai, AK 99611 | 2016-09-19 |
| 1376905000 | Savana Long | Licensed Practical Nurse | 1700 Cone Avenue, Kenai, AK 99611 | 2016-03-22 |
| 1477977684 | Jac Enterprises, Inc. | Assisted Living Facility | 701 North Forest Dr, Kenai, AK 99611 | 2014-02-07 |
| Find all providers in zip 99611 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174097422 | Julie Lynette Dravis | Counselor | 508 S Willow St Ste D, Kenai, AK 99611-6940 | 2019-01-18 |
| 1942849385 | Erica Nicole Long | Counselor | 508 Upland St, Kenai, AK 99611-8026 | 2020-01-02 |
| 1205499092 | Ronald Petterson | Counselor | 508 Upland St, Kenai, AK 99611-8026 | 2019-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306446182 | Anna Marie Luiken | Counselor | 1009 Fred Cir, Anchorage, AK 99515-2654 | 2020-10-29 |
| 1811502859 | Alaska Telemedicine Consultants Inc | Counselor | 12461 Gilead Way, Willow, AK 99699 | 2020-09-15 |
| 1417569963 | Kristina Lynn Hentges | Counselor | 5131 Manytell Ave, Anchorage, AK 99516-4271 | 2020-08-17 |
| 1073121752 | Gina Thara Wall | Counselor | 17601 James Way, Eagle River, AK 99577-9254 | 2020-07-17 |
| 1154947893 | Jo Flesner | Counselor | 17101 Snowmobile Ln Ste 109, Eagle River, AK 99577-7043 | 2020-06-18 |
| 1437778602 | Kirklin Kinney | Counselor | 5801 E Bogard Rd, Wasilla, AK 99654-4267 | 2020-04-08 |
| 1144859703 | Gena Ruth Ornquist | Counselor | 1000 Josselin Ln, Palmer, AK 99645-7110 | 2020-04-06 |
| 1316587173 | Janet Daw | Counselor | 10714 Colville St, Eagle River, AK 99577-8287 | 2020-01-09 |
| 1588209225 | Elena A Martin | Counselor | 68 Willow Cir, Ketchikan, AK 99901-9530 | 2019-11-15 |
| 1841841723 | Danielle N Gutierrez | Counselor | 1528 Richardson Hwy Apt 3, North Pole, AK 99705-5967 | 2019-09-23 |
| Find all providers with the same taxonomy | ||||
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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.