PROVIDENCE HEALTH & SERVICES WASHINGTON
NPI 1477563344
Community/Behavioral Health in Kodiak, AK

Active since August 09, 2006
1818 E REZANOF DR, KODIAK, AK 99615(907) 481-2400(907) 481-2419 Get Directions Write a Review

NPPES record last updated: June 30, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 15, 2025, Sep 3, 2019 (2 updates tracked since 2019).

About Providence Health & Services Washington NPPES

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

PROVIDENCE HEALTH & SERVICES WASHINGTON (NPI 1477563344), doing business as Providence Kodiak Island Counseling Center, is a healthcare organization registered as a community/behavioral health in Kodiak, Alaska and active in the NPI registry since August 2006. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1477563344
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NamePROVIDENCE HEALTH & SERVICES WASHINGTON
Location Address1818 E REZANOF DRKodiak, AK 99615-6505
Mailing AddressPo Box 31001-4162Pasadena, CA 91110-4162 · (907) 486-9500
Fax(907) 481-2419
Organization SubpartNo
Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateAugust 9, 2006
Last NPPES UpdateJune 30, 20262 updates tracked since enumeration
NPPES CertifiedJune 30, 2026
✔ NPI 1477563344 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
License✔ Licensed in AK · 297340
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.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License 297340 (AK)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 297340 (AK)
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X · License 297340 (AK)
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 297340 (AK)
1818 E REZANOF DR, Kodiak, AK 99615

Other Names 1

Doing Business AsProvidence Kodiak Island Counseling Center

Other Identifiers 1

MedicaidMH 2237 & DA2237AK

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Providence Health & Services Washington is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateAlaskaEnrollment IDO20040326001151Non-DME Part B · Clinic/Group PracticeDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

14

Medicare enrollment records show 14 clinicians reassign Medicare billing to Providence Health & Services Washington, which bills Medicare for the services they deliver. Of these, 6 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 5

Mental Health Counselor6
Clinical Social Worker4
Psychiatry2
Marriage and Family Therapist1
Nurse Practitioner1

Clinicians, nearest first (14)

Clinical Social Worker
NPI 1952567828
1818 E REZANOF DR
Kodiak, AK 99615
(907) 481-2400
✔ PECOS✔ Accepts Medicare0.1 mi
Psychiatry
NPI 1598225351
1818 E REZANOF DR
Kodiak, AK 99615
(907) 481-2400
✔ PECOS✔ Accepts Medicare0.1 mi
Clinical Social Worker
NPI 1053172098
1818 E REZANOF DR
Kodiak, AK 99615
(907) 481-2400
✔ PECOS✔ Accepts Medicare0.1 mi
Mental Health Counselor
NPI 1790439966
1818 E REZANOF DR
Kodiak, AK 99615
(907) 481-2432
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1215601877
717 E REZANOF DR
Kodiak, AK 99615
(907) 244-2274
✔ PECOS✔ Accepts Medicare0.9 mi
Mental Health Counselor
NPI 1821421173
3449 E REZANOF DR
Kodiak, AK 99615
(907) 486-7385
✔ PECOS1.2 mi
Mental Health Counselor
NPI 1518584267
10401 SIDOROF LN
Anchorage, AK 99507
(907) 931-9989
✔ PECOS✔ Accepts Medicare249 mi
Marriage and Family Therapist
NPI 1336391887
3760 PIPER ST STE LL139
Anchorage, AK 99508
(907) 563-5006
✔ PECOS251 mi
Mental Health Counselor
NPI 1629291422
911 MEALS AVENUE
Valdez, AK 99686
(078) 352-8389
✔ PECOS✔ Accepts Medicare313 mi
Clinical Social Worker
NPI 1740063064
911 MEALS AVE
Valdez, AK 99686
(907) 835-2838
✔ PECOS✔ Accepts Medicare314 mi
Mental Health Counselor
NPI 1164541991
1215 SW G. STREET
Grants Pass, OR 97526
(541) 476-2373
✔ PECOS✔ Accepts Medicare1,648 mi
Clinical Social Worker
NPI 1972759017
717 MISSION ROAD
Fort Hall, ID 83203
(208) 237-5631
✔ PECOS✔ Accepts Medicare1,997 mi
Psychiatry
NPI 1629027222
502 E 2ND ST
Duluth, MN 55805
(218) 786-8364
✔ PECOS✔ Accepts Medicare2,571 mi
Mental Health Counselor
NPI 1841834058
104 INDEPENDENCE PKWY
Comfort, TX 78013
(830) 285-2256
✔ PECOS3,167 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Health & Services Washington's NPI number?

The NPI number for Providence Health & Services Washington is 1477563344. It was assigned to this organization in the NPPES registry on August 9, 2006. The provider is doing business as Providence Kodiak Island Counseling Center.

Where is Providence Health & Services Washington located?

Providence Health & Services Washington is located at 1818 E Rezanof Dr, Kodiak, AK 99615. The listed phone number is (907) 481-2400.

What is Providence Health & Services Washington's specialty?

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

Is Providence Health & Services Washington enrolled in Medicare?

Yes. Providence Health & Services Washington is registered in the Medicare PECOS enrollment system.

When is Providence Health & Services Washington's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Alaska, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through Providence Health & Services Washington?

According to the CMS Revalidation Reassignment List (October 2026 release), 14 clinicians in 5 Medicare specialties reassign their Medicare billing to Providence Health & Services Washington. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Mental Health Counselor (6), Clinical Social Worker (4) and Psychiatry (2). Of these, 6 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Providence Health & Services Washington accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Providence Health & Services Washington 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 Providence Health & Services Washington was last updated on June 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.