JUBILEE LEADERSHIP ACADEMY (NPI# 1477940419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477940419 |
| Entity Type | Organization |
| Organization Name | JUBILEE LEADERSHIP ACADEMY |
| Practice Address |
29 Jubilee Cir Prescott WA 99348-8607 |
| Practice Telephone | 5097492103 |
| Mailing Telephone | 5097492103 |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-17 |
| Authorized Official Name | MR. KENDALL TODD WAGNER (CLINICAL DIRECTOR) |
| Authorized Official Telephone | 5097492103 |
| Authorized Official Credential | LICSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
29 JUBILEE CIR |
| City | PRESCOTT |
| State | WA |
| Zip Code | 99348-8607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962552844 | Kendall Todd Wagner | Counselor | 29 Jubilee Cir, Prescott, WA 99348-8607 | 2007-01-11 |
| 1548648249 | Leann Griffin | Counselor | 29 Jubilee Cir, Prescott, WA 99348-8607 | 2015-05-13 |
| 1609263789 | Sheila Hair | Counselor | 29 Jubilee Cir, Prescott, WA 99348-8607 | 2015-04-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316965437 | Prescott School District | Local Education Agency (LEA) | 207 South A Street, Prescott, WA 99348-0065 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457959835 | Kristin Moore | Speech-Language Pathologist | 311 S Summit Ave, Prescott, AZ 86303-4115 | 2020-10-16 |
| 1275140972 | Stacy Kit Johns Caligiuri | Clinical Nurse Specialist | 726 Prescott Heights Dr, Prescott, AZ 86301-1542 | 2020-09-26 |
| 1396352290 | Dawn Cherie Bybee | Physical Therapy Assistant | 500 N Us Highway 89 Rm 111, Prescott, AZ 86313-5001 | 2020-09-25 |
| 1578179735 | Az Neurosurgery & Spine, Pllc | Clinic/Center | 371 Garden St # A-27, Prescott, AZ 86305-2914 | 2020-09-22 |
| 1740896646 | Kelly Anne Brewer | Respiratory Therapist, Registered | 500 N. State Route 89, Cpap Clinic, Prescott, AZ 86313 | 2020-09-17 |
| 1891300299 | Roundsville Drug and Alcohol Treatment of Arizona | Counselor | 610 N Bagby Dr, Prescott, AZ 86301-2588 | 2020-09-11 |
| 1851905707 | Skidway Pharmacy LLC | Pharmacy | 1830 Greenwood Rd, Prescott, MI 48756-8627 | 2020-09-08 |
| 1528670650 | Joseph Mccaffrey | Counselor | 4739 S Ponderosa Park Rd, Prescott, AZ 86303-6146 | 2020-08-19 |
| 1619588209 | Teri Sebastian | Counselor | 240 S Montezuma St Ste 201e, Prescott, AZ 86303-4712 | 2020-08-16 |
| 1124639414 | Karissa Bruce | Counselor | 141 S Mccormick St Ste 103, Prescott, AZ 86303-4730 | 2020-08-11 |
| Find all providers in PRESCOTT | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861023905 | Blueprints Therapeutic Services LLC | Community/Behavioral Health | 1065 Northside Dr, Prescott, AZ 86301-1415 | 2020-01-28 |
| 1003372491 | Seaglass Recovery | Community/Behavioral Health | 711 W Gurley St, Prescott, AZ 86305-3621 | 2019-02-11 |
| 1407398621 | Chapter 5 Counseling Center LLC. | Community/Behavioral Health | 973 W Gurley St, Prescott, AZ 86305-2817 | 2016-11-07 |
| 1447640826 | Chapter 5 | Community/Behavioral Health | 726 W Gurley St, Prescott, AZ 86305-3629 | 2015-01-23 |
| 1235529629 | Chapter 5 Counseling Center, LLC | Community/Behavioral Health | 822 W Gurley St, Prescott, AZ 86305-3624 | 2015-01-23 |
| 1508207523 | Recovery In The Pines, LLC | Community/Behavioral Health | 919 12th Place #13, Prescott, AZ 86305 | 2013-07-08 |
| 1528304367 | Catholic Charities Community Services | Community/Behavioral Health | 434 W Gurley St, Prescott, AZ 86301-3616 | 2012-12-26 |
| 1952646002 | Laura Crimmins Pllc | Community/Behavioral Health | 711 Whipple St, Prescott, AZ 86301-1717 | 2012-11-30 |
| 1932453073 | Oasis Addiction Counseling LLC | Community/Behavioral Health | 445 Miller Valley Rd, Prescott, AZ 86301-2925 | 2012-10-26 |
| 1225391402 | Cornerstone Recovery Center | Community/Behavioral Health | 655 W Gurley St, Prescott, AZ 86305-3619 | 2012-06-21 |
| Find all providers in PRESCOTT | ||||
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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.