DR. ELISA YOUNGBLOOD (NPI# 1689703498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689703498 |
| Entity Type | Individual |
| Full Name | DR. ELISA YOUNGBLOOD |
| Credential | PH.D. |
| Practice Address |
1162 Jackson St Ketchikan AK 99901-5771 |
| Practice Telephone | 9076170169 |
| Mailing Telephone | 9076170169 |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2013-08-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
568 | AK | Behavioral Health & Social Service Providers |
| Street Address |
1162 JACKSON ST |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1174159222 | Helene Rae Simpson | Behavior Technician | 201 Deermont St, Ketchikan, AK 99901 | 2020-03-20 |
| 1003295155 | Suzanne Webb | Massage Therapist | 602 Dock St Ste 106, Ketchikan, AK 99901 | 2015-05-22 |
| 1093194342 | Kate Mortensen | Case Manager/Care Coordinator | 2690 Tongass Ave, Ketchikan, AK 99901 | 2015-05-20 |
| 1578879631 | Thomas Peter Ryan | Social Worker | 320 Bawden St. #318, Ketchikan, AK 99901 | 2010-08-27 |
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659911766 | Matthew James Vogler | Psychologist | 3340 Providence Dr Ste 565, Anchorage, AK 99508-4643 | 2020-01-07 |
| 1538640537 | Rachel Suzanne Woods | Psychologist | 2600 Denali St Ste 450, Anchorage, AK 99503-2754 | 2018-08-27 |
| 1003304346 | James Kyle Timmons | Psychologist | 1020 Potlatch Cir, Anchorage, AK 99503-1728 | 2018-04-23 |
| 1679990279 | Daniel Lord | Psychologist | 600 Richardson Drive Community Center, Fort Richardson, Anchorage, AK 99505 | 2014-03-21 |
| 1457780678 | Cody Chipp | Psychologist | 1131 E International Rd, Anchorage, AK 99518-1408 | 2013-11-07 |
| 1932497617 | Life Coach Psychology Plc | Psychologist | 3105 Lakeshore Dr, Suite B102, Anchorage, AK 99517-2806 | 2011-07-15 |
| 1891085007 | Terri Draper | Psychologist | 4320 Diplomacy Drive, Suite 1500, Anchorage, AK 99508 | 2011-04-10 |
| 1720383185 | Nicole Levaillant | Psychologist | Building 786 D Street, Anchorage, AK 99505 | 2011-01-17 |
| 1215231345 | Irmgard Jo Romine | Psychologist | 3980 Dunlap Ave, Fairbanks, AK 99709-3509 | 2011-01-04 |
| 1144549924 | Christopher Scott Brown | Psychologist | 3180 Peger Rd Ste 248, Fairbanks, AK 99709-5485 | 2010-05-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. ELISA YOUNGBLOOD.
| 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.