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BEHAVIORAL HEALTH UNDER 1115 WAIVER
NPI 1124110796
Community/Behavioral Health in Soldotna, AK

Active since September 29, 2006CLIA 02D0951956 · Microscopy
230 E MARYDALE AVE, SOLDOTNA, AK 99669(907) 262-3119(907) 262-9290 Get Directions Write a Review

NPPES record last updated: April 25, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Behavioral Health Under 1115 Waiver NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEHAVIORAL HEALTH UNDER 1115 WAIVER (NPI 1124110796) is a healthcare organization registered as a community/behavioral health in Soldotna, Alaska and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through April 4, 2028 and lists Benjamin J Wright, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124110796
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePENINSULA COMMUNITY HEALTH SERVICES OF ALASKA, INC.
Location Address230 E MARYDALE AVESoldotna, AK 99669-7648
Mailing AddressPo Box 2949Soldotna, AK 99669-2949 · (907) 260-7303 · Fax (907) 260-7358
Phone(907) 262-3119
Fax(907) 262-9290
Organization SubpartNo
Authorized OfficialBenjamin J WrightCeo · (907) 260-7314
Enumeration DateSeptember 29, 2006
Last NPPES UpdateApril 25, 2023
NPPES CertifiedApril 25, 2023
✔ NPI 1124110796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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.
230 E MARYDALE AVE, Soldotna, AK 99669
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Other Names 1

Other NameBehavioral Health Under 1115 Waiver

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 02D0951956

Peninsula Community Health Services, Inc · Soldotna, AK
Active · expires Apr 4, 2028
CLIA Number02D0951956
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateApril 5, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorDr. Stuart Marcotte
Laboratory Phone(907) 262-3119
Laboratory LocationPeninsula Community Health Services, Inc230 E Marydale Ave, Soldotna, AK 99669
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. AMANDA CHRISTINE GARRICK L.C.S.W.
Social Worker (Clinical)
230 E MARYDALE AVE
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 262-3119
LINDSAY HAYGOOD LCSW
Social Worker (Clinical)
230 E MARYDALE AVE
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 262-3119
AMY DAWN-DAY LPC
Counselor (Mental Health)
230 E MARYDALE AVE
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 262-3119
BARBARA RANSOM A.N.P.
Nurse Practitioner (Psychiatric/Mental Health)
230 E MARYDALE AVE, SUITE 2
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 260-3691
DR. PAMELA ANN HAYS PH.D.
Psychologist (Clinical)
230 E MARYDALE AVE, SUITE 2
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 260-3691
ZACHARY MICHAEL HUOT DPT
Physical Therapist
230 E MARYDALE AVE
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 262-3119
KRISTINA GOOLSBY LPC
Counselor (Professional)
230 E MARYDALE AVE
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 260-3691
MS. TOVA BETH SELBY LPC,CDC1
Counselor
230 E MARYDALE AVE, SUITE 2
SOLDOTNA, AK 99669
Kenai Peninsula Borough (907) 260-3691

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peninsula Community Health Services Of Alaska, Inc.'s NPI number?

The NPI number for Peninsula Community Health Services Of Alaska, Inc. is 1124110796. It was assigned to this organization in the NPPES registry on September 29, 2006. The provider is also known as Behavioral Health Under 1115 Waiver.

Where is Peninsula Community Health Services Of Alaska, Inc. located?

Peninsula Community Health Services Of Alaska, Inc. is located at 230 E Marydale Ave, Soldotna, AK 99669. The listed phone number is (907) 262-3119.

What is Peninsula Community Health Services Of Alaska, Inc.'s specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Peninsula Community Health Services Of Alaska, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 02D0951956) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Peninsula Community Health Services Of Alaska, Inc. accept?

Health plans from Moda Health Plan, Inc. list Peninsula Community Health Services Of Alaska, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Peninsula Community Health Services Of Alaska, Inc. was last updated on April 25, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.