MELISSA FACKLER (NPI# 1851945422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851945422 |
| Entity Type | Individual |
| Full Name | MELISSA FACKLER |
| Practice Address |
3050 Fifth Ave Ketchikan AK 99901-5773 |
| Mailing Address |
360 W Benson Blvd Ste 300 Anchorage AK 99503-3953 |
| Practice Telephone | 9072254135 |
| Mailing Telephone | 9075651200 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2020-01-24 |
| Gender Code | F |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215470257 | Melissa Fackler | Registered Nurse | 1350 Northern Blvd Ste 202, Manhasset, NY 11030 | 2016-11-23 |
| 1689035644 | Melissa Fackler | Occupational Therapy Assistant | 18887 County Road 1150, Pioneer, OH 43554-9705 | 2016-03-17 |
| Street Address |
3050 FIFTH AVE |
| City | KETCHIKAN |
| State | AK |
| Zip Code | 99901-5773 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689820979 | Akeela Inc | Community Based Residential Treatment Facility, Mental Illness | 3050 Fifth Ave, Ketchikan, AK 99901 | 2008-08-18 |
| 1407474455 | Jessica Peavy | Case Manager/Care Coordinator | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1962020909 | Kenneth Hook | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1235757287 | Estelle Cowie | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1144848193 | Lance Ho | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1588282537 | Faylene Benito | Case Manager/Care Coordinator | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1831739390 | Jaime Browning | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-01-13 |
| 1669010922 | Akeela Inc | Community/Behavioral Health | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-12-18 |
| 1689218992 | Bobbi Jo Keuken | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-10-30 |
| 1306480611 | Laura Davidson | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-10-30 |
| Find all providers in the same location | ||||
| 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 |
| 1750565438 | Susan Marie Swift | Nurse Practitioner | 21 Jefferson Way, Suite 202, Psychiatry, Ketchikan, AK 99901 | 2007-12-18 |
| 1811185275 | Janet May Widmyer | Registered Nurse | 2960 Tongass Aveune, Suite 403, Ketchikan, AK 99901 | 2007-10-11 |
| Find all providers in zip 99901 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285234419 | Amanda Paulette Gannon | Counselor | 201 Deermount St Fl 2, Ketchikan, AK 99901-6649 | 2020-10-27 |
| 1962020909 | Kenneth Hook | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1235757287 | Estelle Cowie | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1144848193 | Lance Ho | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2020-07-07 |
| 1659901767 | Debra Kinerk | Counselor | 201 Deermount St, Ketchikan, AK 99901-6649 | 2020-01-17 |
| 1790315893 | Jessica Breanne Lutton | Counselor | 201 Deermount St, Ketchikan, AK 99901-6649 | 2020-01-17 |
| 1669002770 | Darryl Anthony Simons | Counselor | 201 Deermount St, Ketchikan, AK 99901-6649 | 2020-01-17 |
| 1447880547 | Christine Marie Furey | Counselor | 201 Deermount St, Ketchikan, AK 99901-6649 | 2020-01-17 |
| 1306480611 | Laura Davidson | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-10-30 |
| 1841844412 | Lonna Gabbard | Counselor | 3050 Fifth Ave, Ketchikan, AK 99901-5773 | 2019-07-31 |
| Find all providers in KETCHIKAN | ||||
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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.