TANCEN WADE (NPI# 1356948863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1356948863 |
Entity Type | Individual |
Full Name | TANCEN WADE |
Practice Address |
542 4th Ave Ste B101 Fairbanks AK 99701-4707 |
Mailing Address |
Po Box 73004 Fairbanks AK 99707-3004 |
Practice Telephone | 9073741097 |
Enumeration Date | 2020-10-07 |
Last Update Date | 2020-10-07 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 175T00000X | Peer Specialist | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AK | 1687081 | 05 |
Street Address |
542 4TH AVE STE B101 |
City | FAIRBANKS |
State | AK |
Zip Code | 99701-4707 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952634420 | Shelissa F Thomas | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701 | 2009-09-15 |
1689274102 | Shaun'trece White | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-26 |
1942800461 | Leann Adams | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-26 |
1205436623 | Arianna Kopp | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-26 |
1497353783 | Heather Suzanna Matumeak | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-09 |
1972100485 | Ashley M Stevens | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-07 |
1760089130 | Jessica Heath-oatman | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-07 |
1093312670 | Jessica Sue Eickermann | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-10-06 |
1699381228 | Jozey Maria Martellaro | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2020-09-18 |
1184277808 | Staysha Kelly | Counselor | 542 4th Ave Ste B101, Fairbanks, AK 99701-4707 | 2019-07-22 |
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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 |
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Taxonomy Code | 175T00000X |
Grouping | Other Service Providers |
Classification | Peer Specialist |
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881293959 | Keyda Samone Harris | Peer Specialist | 1423 Peger Rd, Fairbanks, AK 99709-5169 | 2020-10-20 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1851998223 | Patricia Main | Peer Specialist | 2601 W 34th Ave Apt 7, Anchorage, AK 99517-2142 | 2020-10-07 |
1215552526 | Joshua Dee Engle | Peer Specialist | 1419 S Kittiwake St, Wasilla, AK 99623-9302 | 2020-06-11 |
1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
1699399303 | Jennifer Benton | Peer Specialist | 11932 Town Park Cir, Eagle River, AK 99577-7788 | 2020-05-29 |
1104449800 | Aubrey Danielle Cave | Peer Specialist | 5752 W Kranberry Ln, Wasilla, AK 99623-1050 | 2020-05-28 |
1811534803 | Colleen H Ward-wilson | Peer Specialist | 3600 San Jeronimo Dr Ste 300, Anchorage, AK 99508-2870 | 2019-12-09 |
1538701222 | Betty Jo Shepherd-hebb | Peer Specialist | 4110 Debarr Rd Spc G17, Anchorage, AK 99508-3176 | 2019-10-14 |
1629610563 | Mikko Joseph Barribeau | Peer Specialist | 2762 N Azurite Cir, Wasilla, AK 99654-4540 | 2019-10-11 |
1194366088 | Matalena Suitupe Lokeni | Peer Specialist | 7650 Mayfair Dr Apt C, Anchorage, AK 99502-7212 | 2019-10-02 |
1285280784 | Zoe Dixon | Peer Specialist | 15765 Kingsley Rd, Ninilchik, AK 99639 | 2019-08-12 |
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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.