MR. RAY J DEWILDE (NPI# 1447491758) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447491758 |
| Entity Type | Individual |
| Full Name | MR. RAY J DEWILDE |
| Practice Address |
122 1st Ave Ste 600 Fairbanks AK 99701-4871 |
| Practice Telephone | 9074528251 |
| Enumeration Date | 2009-03-16 |
| Last Update Date | 2009-03-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
122 1ST AVE STE 600 |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-4871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275556144 | Sasha Elizabeth Ericksen | Psychiatry & Neurology | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2006-07-25 |
| 1568061596 | Lucas Daniel Ritter | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4899 | 2020-10-21 |
| 1770106551 | Juliette M Teregeyo | Case Manager/Care Coordinator | 122 1st Ave Ste 600, Fairbanks, AK 99701-4899 | 2020-05-27 |
| 1942832639 | Janessa Nicole Newman | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4899 | 2020-02-10 |
| 1558836221 | William Bruce Gaddis IIi | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4899 | 2018-10-09 |
| 1740531656 | Tanana Chiefs Conference | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2012-10-02 |
| 1396003455 | Morgan Birrell Liddell | Psychiatry & Neurology | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2012-04-26 |
| 1750672861 | Daisy Elizabeth Henry | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2011-04-22 |
| 1386973659 | Eleanore Louise Starr | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2009-12-16 |
| 1497996680 | Carol J Rose | Counselor | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2009-03-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438365 | Jalon Alexander Mccullough | Counselor | 542 4th Ave Ste B-101, Fairbanks, AK 99701-4707 | 2020-08-19 |
| 1881210474 | Restore Incorported | Counselor | 1095 Tena Ave, Fairbanks, AK 99701-1422 | 2020-06-19 |
| 1669094553 | Capricia Rochelle Cunningham | Counselor | 998 Blair Rd Apt A, Fairbanks, AK 99701-3214 | 2020-05-13 |
| 1972122158 | Jessica Robertson | Counselor | 1211 Cushman St, Fairbanks, AK 99701-4680 | 2020-04-08 |
| 1306483755 | Interior Aids Association | Counselor | 710 3rd Avenue, Fairbanks, AK 99701-4455 | 2019-12-04 |
| 1578119681 | Katelyn Finister | Counselor | 542 4th Ave # B101, Fairbanks, AK 99701-4707 | 2019-08-14 |
| 1063064103 | Christine Lynne Johnson | Counselor | 424 Ketchikan Ave, Fairbanks, AK 99701-3737 | 2019-07-09 |
| 1427618768 | Fredrick Holmberg | Counselor | 1729 University Ave S Apt E40, Fairbanks, AK 99709-4976 | 2019-06-18 |
| 1740849819 | Alyssa Marie Agnes | Counselor | 1521 S Cushman St, Fairbanks, AK 99701-6203 | 2019-06-11 |
| 1700441599 | Heather M Cripe | Counselor | 1089 Tazlina Ct, Fairbanks, AK 99701-1421 | 2019-05-07 |
| Find all providers in FAIRBANKS | ||||
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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.