JALON ALEXANDER MCCULLOUGH (NPI# 1104438365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104438365 |
| Entity Type | Individual |
| Full Name | JALON ALEXANDER MCCULLOUGH |
| Practice Address |
542 4th Ave Ste B-101 Fairbanks AK 99701-4707 |
| Mailing Address |
Po Box 73004 Fairbanks AK 99707-3004 |
| Practice Telephone | 9073741097 |
| Practice Fax Number | 9073741062 |
| Mailing Telephone | 9073741097 |
| Mailing Fax Number | 9073741062 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
542 4TH AVE STE B-101 |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-4707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659984987 | Resource Center for Parents & Children, Inc. | Social Worker | 726 26th Ave, Suite #2, Fairbanks, AK 99701 | 2020-08-26 |
| 1134738982 | Aaron Paul Sarauer | Behavior Technician | 3121 Lathrop St., Fairbanks, AK 99701 | 2020-07-28 |
| 1437715505 | Fabienne Rose Marie Siddall | Case Manager/Care Coordinator | 122 1st Avenue, Fairbanks, AK 99701 | 2019-05-14 |
| 1902461957 | Jacqueline Marie Rahm | Counselor | Family Centered Services of Alaska - Rtc, 3101 Lathrop St., Fairbanks, AK 99701 | 2019-05-06 |
| 1821588989 | Corrie Wilson | Nurse Practitioner | 1025 Barnette Street, Fairbanks, AK 99701 | 2018-05-15 |
| 1922519305 | Sarishma Sangeeta Lal | Registered Nurse | 815 2nd Ave Ste 122, Fairbanks, AK 99701 | 2017-10-12 |
| 1245690569 | Christine L Simko | Naturopath | 1275 Sadler Way, Ste 100 Rm 147, Fairbanks, AK 99701 | 2016-02-29 |
| 1932581600 | Jennifer Davis | Registered Nurse | 1025 West Barnette St., Fairbanks, AK 99701 | 2015-06-18 |
| 1700272705 | John D. Zipperer Jr Md, LLC | Clinic/Center | 751 Old Richardson Hwy., Fairbanks, AK 99701 | 2015-04-07 |
| 1578957460 | Mara Justine Becker | Physician Assistant | 1717 W. Cowles St, Fairbanks, AK- ALASKA 99701 | 2015-03-27 |
| Find all providers in zip 99701 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881210474 | Restore Incorported | Counselor | 1095 Tena Ave, Fairbanks, AK 99701-1422 | 2020-06-19 |
| 1669094553 | Capricia Rochelle Cunningham | Counselor | 998 Blair Rd Apt A, Fairbanks, AK 99701-3214 | 2020-05-13 |
| 1972122158 | Jessica Robertson | Counselor | 1211 Cushman St, Fairbanks, AK 99701-4680 | 2020-04-08 |
| 1306483755 | Interior Aids Association | Counselor | 710 3rd Avenue, Fairbanks, AK 99701-4455 | 2019-12-04 |
| 1578119681 | Katelyn Finister | Counselor | 542 4th Ave # B101, Fairbanks, AK 99701-4707 | 2019-08-14 |
| 1063064103 | Christine Lynne Johnson | Counselor | 424 Ketchikan Ave, Fairbanks, AK 99701-3737 | 2019-07-09 |
| 1427618768 | Fredrick Holmberg | Counselor | 1729 University Ave S Apt E40, Fairbanks, AK 99709-4976 | 2019-06-18 |
| 1740849819 | Alyssa Marie Agnes | Counselor | 1521 S Cushman St, Fairbanks, AK 99701-6203 | 2019-06-11 |
| 1700441599 | Heather M Cripe | Counselor | 1089 Tazlina Ct, Fairbanks, AK 99701-1421 | 2019-05-07 |
| 1689239469 | Caleb Luna Thomas | Counselor | 542 4th Ave Ste B, Fairbanks, AK 99701-4707 | 2019-05-07 |
| Find all providers in FAIRBANKS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.