HAVEN (NPI# 1154861086) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154861086 |
| Entity Type | Organization |
| Organization Name | HAVEN |
| Practice Address |
626 Cordova St Ste 102 Anchorage AK 99501-3783 |
| Mailing Address |
7212 Oyster Ln Wilmington NC 28411-7132 |
| Practice Telephone | 9103993927 |
| Practice Fax Number | 8557741303 |
| Mailing Telephone | 9103993927 |
| Mailing Fax Number | 9103993928 |
| Enumeration Date | 2017-02-25 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | DWIGHT HOWARD LYSNE (DIRECTOR) |
| Authorized Official Telephone | 9103993927 |
| Authorized Official Credential | MD, MDIV |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
118712 | AK | Allopathic & Osteopathic Physicians |
| N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
118712 | AK | Allopathic & Osteopathic Physicians |
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
118712 | AK | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578920120 | Haven | Counselor | 1996 Little Cottage Ln Apt 9, Bozeman, MT 59715-9440 | 2016-01-26 |
| 1184055436 | Haven | Psychiatry & Neurology | 20 S 16th St, Wilmington, NC 28401-4924 | 2013-12-11 |
| 1285862292 | Haven | Psychiatry & Neurology | 20 S 16th St, Wilmington, NC 28401-4924 | 2009-06-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | HAVEN | 5974 Trilogy St Se, Salem, OR 97306 |
| System for Award Management (SAM) Entities | HAVEN | 1106 E 8th St, Merrill, WI 54452-1113 |
| Washington State Corporations | HAVEN & FISKE, LLC | 112 N Haven St #b, Spokane, WA 99202 |
| Vermont Business Registrations | HAVEN & SON TOWING, INC. | Rt 4a, Ctr Rutland, VT 05763 |
| Alabama Business Registrations | Haven (Be lovely. Be happy. Be inspired.) LLC | 203 Atwater Drive, Madison, AL 35756 |
| Washington State Corporations | HAVEN - AVONDALE, LLC | 449 S Beverly Dr Ste 100, Beverly Hills, CA 90212 |
| Oregon Corporations, Companies and Business Names | HAVEN - HOME OF BEND | 856 Nw Bond St Ste 1, Bend, OR 97701 |
| New York State Corporations | HAVEN 100 PROJECT LLC | 15 Cobblestone Court, Orchard Park, Ny 14127 |
| Colorado Business Entities | Haven 127 at Eastlake Station | One North Wacker Drive, Ste 2402, Chicago, IL 60606 |
| New York State Corporations | HAVEN 172 LLC | 2504 40th Ave., Long Island City, Ny 11101 |
| Street Address |
626 CORDOVA ST STE 102 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99501-3783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093304 | Ryan Garcia | Military Health Care Provider | 673d Med Group, Jber, AK 99501 | 2020-11-02 |
| 1033755798 | The Salvation Army, A California Corporation | Community/Behavioral Health | 1700 A Street, Anchorage, AK 99501 | 2019-11-18 |
| 1740841170 | Christina Lynne Arent Cook | Registered Nurse | 8000 West End Rd, Anchorage, AK 99501 | 2019-06-26 |
| 1033770672 | Kathy Eileen Mailelle | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-25 |
| 1306312574 | Patricia Estella Gould | Marriage & Family Therapist | 731 N St, Anchorage, AK 99501 | 2018-10-15 |
| 1497235642 | Beth Alta Fletcher | Specialist | 737 W 5th Ave Ste 202, Anchorage, AK 99501 | 2018-08-17 |
| 1699289645 | Jae Won Lee | Dentist | 726 E. 9th Avenue, Anchorage, AK 99501 | 2017-11-29 |
| 1649797796 | Seong Guy Hyung | Dentist | 726 E 9th Avenue, Anchorage, AK 99501 | 2017-08-29 |
| 1871952705 | Warren Anderson | Massage Therapist | 737 West 5th Avenue Suite 202, Anchorage, AK 99501 | 2016-02-20 |
| 1780072603 | Epoch - Alaska Limited Liability Company | General Practice | 3074 Mt. View Drive, Suite 193, Anchorage, AK 99501 | 2014-12-30 |
| Find all providers in zip 99501 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942781562 | Anchorage Psychiatry | Psychiatry & Neurology | 1120 Huffman Rd Ste 24, Anchorage, AK 99515-3516 | 2018-08-22 |
| 1821453937 | Dr, Deborah Guris LLC | Psychiatry & Neurology | 15630 Stanwood Cir, Anchorage, AK 99516-4866 | 2015-12-17 |
| 1225378664 | Shirley Ann Saucerman | Psychiatry & Neurology | 336 W 10th Ave, Anchorage, AK 99501-3501 | 2013-02-21 |
| 1336408335 | Melinda M Hansen | Psychiatry & Neurology | 4501 Diplomacy Drive, Southcentral Foundation, Anchorage, AK 99508-0000 | 2012-05-10 |
| 1548420920 | Willow, LLC | Psychiatry & Neurology | 920 E 72nd Ave, Anchorage, AK 99518-2810 | 2008-06-10 |
| 1992987655 | Jonathan Benaknin | Psychiatry & Neurology | Anchorage Native Primary Care Center, 4320 Diplomacy Drive, Anchorage, AK 99508 | 2007-12-04 |
| 1548452519 | Clare Louise Maxwell | Psychiatry & Neurology | 1231 Gambell St Ste 300, Anchorage, AK 99501 | 2007-08-14 |
| 1447441944 | Jay Hugh Ehly | Psychiatry & Neurology | 200 W 34th Ave, Pmb 1204, Anchorage, AK 99503-3969 | 2007-08-08 |
| 1609070374 | Sarah Tighe Mccutcheon | Psychiatry & Neurology | Greatland Clinical Associates, 1400 W Benson Blvd Ste 315, Anchorage, AK 99503 | 2007-06-14 |
| 1881727923 | Wandal William Winn | Psychiatry & Neurology | 4300 B St Ste 202, Anchorage, AK 99503-5951 | 2007-03-14 |
| 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.