BENDICK J DIDRICKSON (NPI# 1568791671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568791671 |
| Entity Type | Individual |
| Full Name | BENDICK J DIDRICKSON |
| Credential | CSFW |
| Practice Address |
4300 University Dr Juneau AK 99801-8649 |
| Practice Telephone | 9073644445 |
| Mailing Telephone | 9073644445 |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |
| 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) |
2180 | AK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | STATE LICENSE | 2180 | 01 |
| Street Address |
4300 UNIVERSITY DR |
| City | JUNEAU |
| State | AK |
| Zip Code | 99801-8649 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619295417 | Jeremiah C Byers | Community Health Worker | 4300 University Dr, Juneau, AK 99801-8649 | 2010-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| 1134743313 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3800 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1235753419 | Juneau Youth Services, Inc. | Community/Behavioral Health | 9001 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-03 |
| 1043834245 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Loop Rd, Juneau, AK 99801 | 2020-06-03 |
| 1295359511 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10801 Black Bear Rd, Juneau, AK 99801 | 2020-06-02 |
| 1700400033 | Juneau Youth Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 10685 Mendenhall Lp Rd, Juneau, AK 99801 | 2020-06-02 |
| 1831733351 | Monalisa Vaolete Lauofo | Counselor | 5594 Aisek Street, Juneau, AK 99801 | 2019-10-29 |
| 1245873033 | Ryan Isadore | Counselor | 1613 Anka Street, Juneau, AK 99801 | 2019-10-24 |
| Find all providers in zip 99801 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831733351 | Monalisa Vaolete Lauofo | Counselor | 5594 Aisek Street, Juneau, AK 99801 | 2019-10-29 |
| 1245873033 | Ryan Isadore | Counselor | 1613 Anka Street, Juneau, AK 99801 | 2019-10-24 |
| 1629241153 | Kimberly Ann Kunz | Counselor | 199 County Rd Df, Juneau, WI 53039 | 2008-04-04 |
| 1316159098 | Catherine Ann Wellwood | Counselor | 3245 Hospital Dr Ste 109, Juneau, AK 99801-7809 | 2007-05-04 |
| 1770197352 | Lara Ann Von | Counselor | 5597 Aisek St, Juneau, AK 99801-9522 | 2020-09-01 |
| 1114569969 | Heather L. Vogel | Counselor | 5597 Aisek Street, Juneau, AK 99801 | 2019-10-14 |
| 1770133811 | Milton Michael Rowcroft | Counselor | 5597 Aisek Street, Juneau, AK 99801 | 2019-09-19 |
| 1376190462 | Susanne Coleman | Counselor | 2075 Jordan Ave, Juneau, AK 99801-8095 | 2019-08-22 |
| 1659925055 | Bradford Parfitt | Counselor | 5597 Aisek Street, Juneau, AK 99801 | 2019-07-25 |
| 1710530100 | Robert Sharclane | Counselor | 5597 Aisek Street, Juneau, AK 99801 | 2019-07-24 |
| Find all providers in JUNEAU | ||||
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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.