PROVIDENCE VALDEZ COUNSELING CENTER (CITY OF VALDEZ) NPI 1962525097

Clinic/Center (Mental Health (Including Community Mental Health Center)) in Valdez, AK

NPI 1962525097 Organization Clinic/Center Mental Health (Including Community Menta...

About PROVIDENCE VALDEZ COUNSELING CENTER (CITY OF VALDEZ)

Providence Valdez Counseling Center (city Of Valdez) is a provider established in Valdez, Alaska specializing in clinic/center (mental health (including community mental health center)) . The NPI number of Providence Valdez Counseling Center (city Of Valdez) is 1962525097 and was assigned on April 2007. The practitioner's primary taxonomy code is 261QM0801X with license number NOT NUMBERED (AK). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Providence Valdez Counseling Center. The authorized official of this NPI record is Mr. Jeremy O'neil (Administrator)

NPI

1962525097

Provider NamePROVIDENCE VALDEZ COUNSELING CENTER (CITY OF VALDEZ)
Provider Location Address911 MEALS AVENUE VALDEZ, AK 99686
Provider Mailing AddressPO BOX 550 VALDEZ, AK 99686
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Other Organization NamePROVIDENCE VALDEZ COUNSELING CENTER
Other Name TypeDoing Business As (3)
Enumeration Date04-06-2007
Last Update Date04-20-2016


Primary Taxonomy

Taxonomy Code261QM0801X
ClassificationClinic/Center
TypeAmbulatory Health Care Facilities
SpecializationMental Health (Including Community Mental Health Center)
License No.NOT NUMBERED
License StateAK

Business Address

PROVIDENCE VALDEZ COUNSELING CENTER
911 MEALS AVENUE
VALDEZ, AK
ZIP 99686
Phone: (907) 835-2838
Fax: (907) 834-1890

Get Directions


Mailing Address

PROVIDENCE VALDEZ COUNSELING CENTER
PO BOX 550
VALDEZ, AK
ZIP 99686
Phone: (907) 835-2838
Fax: (907) 834-1890



Authorized Official

Authorized Official NameMR. JEREMY O'NEIL
Authorized Official TitleADMINISTRATOR
Authorized Official Phone(907) 835-2249

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
MH2096MEDICAID (05)AK

Other Providers at the same location


The following 9 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1518177039MS. ANGELA GIGI OBREN MSPT
Individual
Physical Therapist911 MEALS AVENUE
VALDEZ, AK 99686
(907) 834-1862
1417168360 SHANNON M MAHONEY OTRL
Individual
Occupational Therapist911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1790715928CITY OF VALDEZ
Organization
Skilled Nursing Facility911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1336247824CITY OF VALDEZ
Organization
Medicare Defined Swing Bed Unit911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1427424282CITY OF VALDEZ
Organization
Clinic/Center (Critical Access Hospital)911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1225151327CITY OF VALDEZ
Organization
Clinic/Center (Rehabilitation, Substance Use Disorder)911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2838
1952404865CITY OF VALDEZ
Organization
Ambulance (Land Transport)911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1073929758 CORINA HOPKINS-VACCA MD
Individual
Family Medicine911 MEALS AVENUE
VALDEZ, AK 99686
(907) 835-2249
1629291422 EDMORE MANGENA LPC
Individual
Counselor (Professional)911 MEALS AVENUE
VALDEZ, AK 99686
(078) 352-8389

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.