| Providence Valdez Counseling Center | |
|
911 Meals Avenue Valdez AK 99686 | |
| (907) 835-2838 | |
| (907) 834-1890 |
| Full Name | Providence Valdez Counseling Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 911 Meals Avenue, Valdez, Alaska |
| Authorized Official Name and Position | Jeremy O'neil (ADMINISTRATOR) |
| Authorized Official Contact | 9078352249 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Valdez Counseling Center Po Box 550 Valdez AK 99686-0550 Ph: (907) 835-2838 | Providence Valdez Counseling Center 911 Meals Avenue Valdez AK 99686 Ph: (907) 835-2838 |
| NPI Number | 1962525097 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 04/20/2016 |
| Medicare PECOS PAC ID | 9931261005 |
|---|---|
| Medicare Enrollment ID | O20081224000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962525097 | NPI | - | NPPES |
| MH2096 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | NOT NUMBERED (Alaska) | Primary |
| Provider Name | Ronnie B Burns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629027222 PECOS PAC ID: 0648293894 Enrollment ID: I20110818000830 |
| Provider Name | Belinda K Chambers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952567828 PECOS PAC ID: 9739243791 Enrollment ID: I20210601001128 |
| Provider Name | Amber Wellner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215601877 PECOS PAC ID: 1153728282 Enrollment ID: I20210916000967 |
| Provider Name | Clancy Halsted |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043837446 PECOS PAC ID: 0840679486 Enrollment ID: I20220628001128 |
| Provider Name | Carolyn Claire Craig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598225351 PECOS PAC ID: 4385973056 Enrollment ID: I20230824004034 |
| Provider Name | Tahnee R King |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740063064 PECOS PAC ID: 4183087372 Enrollment ID: I20230906001969 |
| Provider Name | Brandy Stratman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730347253 PECOS PAC ID: 9830546357 Enrollment ID: I20231106001025 |
| Provider Name | James M Price |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1821421173 PECOS PAC ID: 4486005543 Enrollment ID: I20240112002740 |
| Provider Name | Edmore Mangena |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629291422 PECOS PAC ID: 7911358072 Enrollment ID: I20240112002787 |
| Provider Name | Kyra A Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831973783 PECOS PAC ID: 8224481304 Enrollment ID: I20240124004158 |