MR. JOHN B. HENLEY III (NPI# 1730723156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730723156 |
| Entity Type | Individual |
| Full Name | MR. JOHN B. HENLEY III |
| Practice Address |
5594 Aisek Street Juneau AK 99801 |
| Mailing Address |
5597 Aisek Street Juneau AK 99801 |
| Practice Telephone | 9077803037 |
| Practice Fax Number | 9077803053 |
| Mailing Telephone | 9077803037 |
| Mailing Fax Number | 9077803053 |
| Enumeration Date | 2019-10-29 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | AK | Other Service Providers |
| Street Address |
5594 AISEK STREET |
| City | JUNEAU |
| State | AK |
| Zip Code | 99801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831733351 | Monalisa Vaolete Lauofo | Counselor | 5594 Aisek Street, Juneau, AK 99801 | 2019-10-29 |
| 1871137596 | Gastineau Human Services | Case Manager/Care Coordinator | 5594 Aisek Street, Juneau, AK 99801 | 2019-11-06 |
| 1699319319 | Gastineau Human Services | Case Manager/Care Coordinator | 5594 Aisek Street, Juneau, AK 99801 | 2019-11-06 |
| 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 |
| 1245873033 | Ryan Isadore | Counselor | 1613 Anka Street, Juneau, AK 99801 | 2019-10-24 |
| 1871134510 | Jessica Dean | Behavior Technician | 17200 Point Lena Loop Road, Juneau, AK 99801 | 2019-10-03 |
| Find all providers in zip 99801 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649814849 | Ryan Bradshaw | Peer Specialist | 3406 Glacier Hwy, Juneau, AK 99801-7251 | 2019-10-30 |
| 1912568478 | William Musser | Peer Specialist | 3406 Glacier Hwy, Juneau, AK 99801-7251 | 2019-06-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851998223 | Patricia Main | Peer Specialist | 2601 W 34th Ave Apt 7, Anchorage, AK 99517-2142 | 2020-10-07 |
| 1215552526 | Joshua Dee Engle | Peer Specialist | 1419 S Kittiwake St, Wasilla, AK 99623-9302 | 2020-06-11 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1699399303 | Jennifer Benton | Peer Specialist | 11932 Town Park Cir, Eagle River, AK 99577-7788 | 2020-05-29 |
| 1104449800 | Aubrey Danielle Cave | Peer Specialist | 5752 W Kranberry Ln, Wasilla, AK 99623-1050 | 2020-05-28 |
| 1811534803 | Colleen H Ward-wilson | Peer Specialist | 3600 San Jeronimo Dr Ste 300, Anchorage, AK 99508-2870 | 2019-12-09 |
| 1538701222 | Betty Jo Shepherd-hebb | Peer Specialist | 4110 Debarr Rd Spc G17, Anchorage, AK 99508-3176 | 2019-10-14 |
| 1629610563 | Mikko Joseph Barribeau | Peer Specialist | 2762 N Azurite Cir, Wasilla, AK 99654-4540 | 2019-10-11 |
| 1194366088 | Matalena Suitupe Lokeni | Peer Specialist | 7650 Mayfair Dr Apt C, Anchorage, AK 99502-7212 | 2019-10-02 |
| 1285280784 | Zoe Dixon | Peer Specialist | 15765 Kingsley Rd, Ninilchik, AK 99639 | 2019-08-12 |
| 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.