BOYS AND GIRLS HOME OF ALASKA (NPI# 1225338189) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225338189 |
| Entity Type | Organization |
| Organization Name | BOYS AND GIRLS HOME OF ALASKA |
| Practice Address |
3101 Lathrop St Fairbanks AK 99701-7426 |
| Practice Telephone | 7122934700 |
| Practice Fax Number | 7122934800 |
| Mailing Telephone | 7122934700 |
| Mailing Fax Number | 7122934800 |
| Enumeration Date | 2010-10-26 |
| Last Update Date | 2010-10-26 |
| Authorized Official Name | DR. RICHARD C BROWN JR. (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7122934700 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | BOYS AND GIRLS HOME AND FAMILY SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457528366 | Boys and Girls Home of Alaska | Residential Treatment Facility, Emotionally Disturbed Children | 3101 Lathrop Street, Fairbanks, AK 99707-0870 | 2008-05-09 |
| 1255631446 | Boys and Girls Home of Alaska | Community Based Residential Treatment Facility, Mental Illness | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2010-10-22 |
| Street Address |
3101 LATHROP ST |
| City | FAIRBANKS |
| State | AK |
| Zip Code | 99701-7426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609088491 | Ted Campbell | Counselor | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2007-05-04 |
| 1164029161 | Amanda Young | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-03 |
| 1699372623 | Iesha Nicole Little-robinson | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1730786765 | Victor Ramon Pichardo Nunez | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1467059493 | Alissa Merrily Allen | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1053918078 | Abigail Scott | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-10-02 |
| 1326657412 | Eric Enlow | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1659980746 | Alisha Gail | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1467061564 | Anjoli D. Anderson | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| 1609485796 | Brionna Leigh Yannello | Behavior Technician | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2020-07-24 |
| Find all providers in the same location | ||||
| 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 | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346894789 | Jereme T. Vaughan | Psychiatry & Neurology | 3101 Lathrop St, Fairbanks, AK 99701-7426 | 2019-07-24 |
| 1568671766 | Wendell Street Psychiatric LLC | Psychiatry & Neurology | 225 Wendell St, Ste B, Fairbanks, AK 99701-4835 | 2007-05-22 |
| 1851360838 | Vanessa A. Venezia | Psychiatry & Neurology | 1650 Cowles St, Fairbanks, AK 99701-5907 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750988549 | Daniel J Mardones Md Inc | Psychiatry & Neurology | 2523 Debarr Road, Anchorage, AK 99508-2948 | 2020-10-05 |
| 1639496243 | Kelton Manor Thomas | Psychiatry & Neurology | 5855 Zeamer Ave, Anchorage, AK 99506 | 2010-04-23 |
| 1275665085 | Phillip Neuberger | Psychiatry & Neurology | 3201 C St, Suite 302, Anchorage, AK 99503-3917 | 2007-03-09 |
| 1033263439 | Michael D Robertson | Psychiatry & Neurology | 1709 Bragaw St, Suite A, Anchorage, AK 99508-3436 | 2007-01-22 |
| 1780793448 | Alina Nicole Schneider | Psychiatry & Neurology | 1650 South Bragaw Street, Anchorage, AK 99508 | 2006-08-29 |
| 1982625596 | Lina Judith Bautista | Psychiatry & Neurology | 2800 Providence Dr, Anchorage, AK 99508-4623 | 2006-07-21 |
| 1194705475 | Daniel Mardones | Psychiatry & Neurology | 2530 Debarr Rd, Anchorage, AK 99508-2948 | 2006-01-20 |
| 1942296694 | John Francis Forbes | Psychiatry & Neurology | 673 Mdg, 5955 Zeamer Avenue, Jber, AK 99506-9950 | 2005-09-27 |
| 1770583932 | Claudia Berenson | Psychiatry & Neurology | 4001 Dale St Ste 101, Anchorage, AK 99508-5444 | 2005-07-28 |
| 1285055731 | Baisi Psychiatric Services LLC | Psychiatry & Neurology | 2530 Debarr Rd, Anchorage, AK 99508-2948 | 2013-12-31 |
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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.