WISDOM TRADITIONS COUNSELING SERVICES, LLC (NPI# 1881879922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881879922 |
| Entity Type | Organization |
| Organization Name | WISDOM TRADITIONS COUNSELING SERVICES, LLC |
| Other Organization Name | ALASKA WISDOM RECOVERY |
| Practice Address |
401 W International Rd Ste 27 Anchorage AK 99518-1168 |
| Mailing Address |
401 W International Rd Ste 17 Anchorage AK 99518-1181 |
| Practice Telephone | 9075624540 |
| Practice Fax Number | 9075624502 |
| Mailing Telephone | 9077703656 |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2019-08-26 |
| Authorized Official Name | MR. MICHAEL W. DEMOLINA (OWNER) |
| Authorized Official Telephone | 9075624540 |
| Authorized Official Credential | MS, LPC |
| Is Organization Subpart | Y |
| Parent Organization Name | WISDOM TRADITIONS COUNSELING SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Alaska Wisdom Recovery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518582063 | Wisdom Traditions Counseling Services, LLC | Community/Behavioral Health | 401 W International Airport Rd Ste 17, Anchorage, AK 99518-1168 | 2020-06-10 |
| 1467775676 | Wisdom Traditions Counseling Services, LLC | Clinic/Center | 401 W International Airport Rd Ste 17, Anchorage, AK 99518 | 2010-03-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WISDOM TRADITIONS COUNSELING SERVICES, LLC. | 401 W International Airport Rd Ste 17, Anchorage, AK 99518-1168 |
| Street Address |
401 W INTERNATIONAL RD STE 27 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99518-1168 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871952648 | Daniel & Max, LLC | Optometrist | 8300 Homer Drive, Anchorage, AK 99518 | 2016-02-22 |
| 1093133266 | Bidney Turner | Registered Nurse | 8130 Old Sweard Highway, Suite #103, Anchorage, AK 99518 | 2014-04-03 |
| 1407271265 | Diane Clare Espinosa | Speech-Language Pathologist | 708 Blackburn Ct., Anchorage, AK 99518 | 2014-03-03 |
| 1366865859 | Infinite Care of Alaska LLC | Home Health | 165 East 56th Ave., Suite #3, Anchorage, AK 99518 | 2014-02-04 |
| 1669712477 | Medical Services | Durable Medical Equipment & Medical Supplies | 5401 North Star St, Anchorage, AK 99518 | 2013-02-15 |
| 1346503364 | Eric Mellor Larsen | Social Worker | 5308 Northstar St, Anchorage, AK 99518 | 2012-06-25 |
| 1245443662 | Wisdom Traditions Wellness, LLC | Acupuncturist | 615 E 82nd Avenue Suite B-5, Suite #17, Anchorage, AK 99518 | 2007-05-08 |
| 1902929813 | Stannealh Inc. 2 | Residential Treatment Facility, Physical Disabilities | 7452 Nathan Dr., Anchorage, AK 99518 | 2007-04-06 |
| 1679641500 | Annett Marie Pipkin | Specialist | 5401 Northstar, #a, Anchorage, AK 99518 | 2006-11-30 |
| 1922172022 | Mark E Silverman | Dentist | 7926 Old Seward Hwy, Ste B7, Anchorage, AK 99518 | 2006-11-20 |
| Find all providers in zip 99518 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1184259855 | Alaska Youth and Family Network | Community/Behavioral Health | 740 Communications Ave, Anchorage, AK 99503-6000 | 2020-03-03 |
| 1033755798 | The Salvation Army, A California Corporation | Community/Behavioral Health | 1700 A Street, Anchorage, AK 99501 | 2019-11-18 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1558878231 | Pinnacle Community Health, LLC | Community/Behavioral Health | 8080 Opal Cir, Anchorage, AK 99502-4542 | 2018-01-04 |
| 1497272470 | David Root | Community/Behavioral Health | 207 E Northern Lights Blvd Ste 212, Anchorage, AK 99503-2731 | 2017-08-29 |
| 1306393012 | Deon Burns | Community/Behavioral Health | 12725 Landmark St Apt B, Anchorage, AK 99515-3818 | 2016-09-10 |
| 1386199339 | Pcr Alaska LLC | Community/Behavioral Health | 1413 W 31st Ave, Anchorage, AK 99503-3624 | 2016-08-19 |
| Find all providers in ANCHORAGE | ||||
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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.