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PROVIDENCE KODIAK ISLAND COUNSELING CENTER
NPI 1376141929
Community/Behavioral Health in Kodiak, AK

Active since October 15, 2020
717 E REZANOF DR, KODIAK, AK 99615(907) 481-2400(907) 481-2419 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2025, Oct 15, 2020 (2 updates tracked since 2020).

About Providence Kodiak Island Counseling Center NPPES

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

PROVIDENCE KODIAK ISLAND COUNSELING CENTER (NPI 1376141929) is a healthcare organization registered as a community/behavioral health in Kodiak, Alaska and active in the NPI registry since October 2020. The organization lists Donald W Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1376141929
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePROVIDENCE KODIAK ISLAND COUNSELING CENTER
Location Address717 E REZANOF DRKodiak, AK 99615-6416
Mailing AddressPo Box 3290Portland, OR 97208-3290 · (907) 481-2000
Phone(907) 481-2400
Fax(907) 481-2419
Organization SubpartNo
Authorized OfficialDonald W AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateOctober 15, 2020
Last NPPES UpdateMay 15, 20252 updates tracked since enumeration
NPPES CertifiedMay 15, 2025
✔ NPI 1376141929 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.
717 E REZANOF DR, Kodiak, AK 99615
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Other Providers at the Same Location NPPES 18

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

MRS. CHRISTINE FORD RN
Registered Nurse
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2400
PROVIDENCE KODIAK ISLAND COUNSELING CENTER
Case Management
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2400
STEPHANIE M MCCARTER
Counselor (Mental Health)
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2434
JENNIFER M NEWMAN
Case Manager/Care Coordinator
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2400
AMBER WELLNER ANP
Nurse Practitioner (Psychiatric/Mental Health)
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 244-2274
PUREZA VILLARAN
Case Manager/Care Coordinator
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2429
CHRISTINE L FOSTER
Counselor (Mental Health)
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2400
MRS. LAURA LYNETTE GRIFFIN BACHELORS OF SCIENCE
Case Manager/Care Coordinator
717 E REZANOF DR
KODIAK, AK 99615
Kodiak Island Borough (907) 481-2426

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 Providence Kodiak Island Counseling Center's NPI number?

The NPI number for Providence Kodiak Island Counseling Center is 1376141929. It was assigned to this organization in the NPPES registry on October 15, 2020.

Where is Providence Kodiak Island Counseling Center located?

Providence Kodiak Island Counseling Center is located at 717 E Rezanof Dr, Kodiak, AK 99615. The listed phone number is (907) 481-2400.

What is Providence Kodiak Island Counseling Center's specialty?

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

When was this NPI record last updated?

The NPPES record for Providence Kodiak Island Counseling Center was last updated on May 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.