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PRENTISS J PEMBERTON LCSW
NPI 1902027832
Social Worker - Clinical in Anchorage, AK

Active since May 01, 2007Opted out of Medicare · through Feb 24, 2027
4105 TUDOR CENTRE DRIVE, ANCHORAGE, AK 99508(907) 565-4000(907) 565-4011 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Prentiss J Pemberton Lcsw NPPES

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

PRENTISS J PEMBERTON LCSW (NPI 1902027832) is an individual clinical provider in Anchorage, Alaska, licensed in Alaska (732) and active in the NPI registry since May 2007. He has opted out of Medicare through February 24, 2027.

NPPES Registry Identity

NPI1902027832
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NamePRENTISS J PEMBERTONCredential: LCSW
Location Address4105 TUDOR CENTRE DRIVEAnchorage, AK 99508
Mailing Address4105 Tudor Centre DriveAnchorage, AK 99508 · (907) 565-4000 · Fax (907) 565-4011
Phone(907) 565-4000
Fax(907) 565-4011
Sole ProprietorNo
Enumeration DateMay 1, 2007
Last NPPES UpdateJuly 9, 2007
✔ NPI 1902027832 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in AK · 732
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4105 TUDOR CENTRE DRIVE, Anchorage, AK 99508
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Other Identifiers 1

MedicaidMH6578AK

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Prentiss J Pemberton Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 24, 2025 through February 24, 2027.

Opt-Out Effective DateFebruary 24, 2025
Opt-Out In Effect ThroughFebruary 24, 2027Opt-out affidavits renew automatically every two years unless cancelled

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 Prentiss Pemberton's NPI number?

The NPI number for Prentiss Pemberton is 1902027832. It was assigned to this individual provider in the NPPES registry on May 1, 2007.

Where is Prentiss Pemberton located?

Prentiss Pemberton practices at 4105 Tudor Centre Drive, Anchorage, AK 99508. The listed phone number is (907) 565-4000.

What is Prentiss Pemberton's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Prentiss Pemberton enrolled in Medicare?

No. Prentiss Pemberton has opted out of Medicare through February 24, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Prentiss Pemberton accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Prentiss Pemberton 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 Prentiss Pemberton was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.