SOUTHCENTRAL FOUNDATION (NPI# 1124686076) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124686076 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
4441 Diplomacy Dr Anchorage AK 99508-5910 |
| Mailing Address |
Po Box 35198 Seattle WA 98124-5198 |
| Practice Telephone | 9077294955 |
| Practice Fax Number | 9077298607 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |
| Authorized Official Name | CHRISTOPHER TAYLOR (SUPERVISOR OF PROVIDER ENROLLMENT) |
| Authorized Official Telephone | 9077295418 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466204 | Southcentral Foundation | Clinic/Center | 11495 N Callison St, Sutton, AK 99674 | 2020-08-06 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1720548035 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 | 2019-03-22 |
| 1750854089 | Southcentral Foundation | Clinic/Center | 400 W Benson Blvd, Anchorage, AK 99503-3829 | 2019-01-09 |
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1043767940 | Southcentral Foundation | Dentist | 11495 N. Callison Street, Sutton, AK 99674 | 2016-09-08 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| Street Address |
4441 DIPLOMACY DR |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588862684 | Patricia Jane Clark Capo | Obstetrics & Gynecology | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2007-07-10 |
| 1861010100 | Emani Secret | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-07-13 |
| 1720603095 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-06-12 |
| 1598399602 | Alex John Olson | Student in an Organized Health Care Education/Training Program | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-02-27 |
| 1124666730 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-13 |
| 1962040634 | Southcentral Foundation | Psychologist | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-12 |
| 1659924108 | Southcentral Foundation | Community/Behavioral Health | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-07-23 |
| 1538721741 | Malcolm Henry Nichols | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-07-08 |
| 1750948170 | Allison Margaret Capps | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-05-21 |
| 1134786734 | Stephanie Lee Douglas | Licensed Practical Nurse | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-05-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 103K00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavioral Analyst |
| A behavior analyst is qualified by at least a master’s degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans. |
| Notes: Source: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2008: new, 1/1/2016: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588298269 | Brandy Jones | Behavioral Analyst | 2018 Brandilyn St, Anchorage, AK 99516-1960 | 2020-03-02 |
| 1992357065 | John Christian Sturm | Behavioral Analyst | 7013 Saturn Cir, Anchorage, AK 99504-4564 | 2019-07-09 |
| 1295201192 | Melinda Mcgrew | Behavioral Analyst | 8116 Sandy Cir, Anchorage, AK 99507-3284 | 2018-10-17 |
| 1720439367 | Phillip Tafs | Behavioral Analyst | 2728 Mccollie Ave, Anchorage, AK 99517-1271 | 2016-06-24 |
| 1578946638 | Branwen Rose Collier | Behavioral Analyst | 2836 Kimberlie Court, Anchorage, AK 99508 | 2015-07-07 |
| 1932507712 | Kimberley Benton Burnett | Behavioral Analyst | 2019 Brandilyn St, Anchorage, AK 99516-1963 | 2014-12-10 |
| 1578981254 | Carl Gunther V | Behavioral Analyst | 2780 Trailside Loop Unit C, Anchorage, AK 99507-4276 | 2014-03-31 |
| 1063755965 | Lindsey Harpole | Behavioral Analyst | 3231 Michigan Ave, Anchorage, AK 99516-1448 | 2013-03-29 |
| 1447595129 | Antonina Ivanovna Shangraw | Behavioral Analyst | 2425 Captain Cook Dr, Anchorage, AK 99517 | 2012-12-06 |
| 1518285881 | Santiago M Maniti | Behavioral Analyst | 3413 E 17th Ave, Anchorage, AK 99508-3358 | 2010-05-12 |
| Find all providers in ANCHORAGE | ||||
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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.