GREEN PSYCHOLOGICAL SERVICES, LLC (NPI# 1548613243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548613243 |
| Entity Type | Organization |
| Organization Name | GREEN PSYCHOLOGICAL SERVICES, LLC |
| Practice Address |
634 S Bailey St 106 Palmer AK 99645-6360 |
| Practice Telephone | 9076312807 |
| Mailing Telephone | 9076312807 |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2016-07-18 |
| Authorized Official Name | DR. WILLIAM KERST (OWNER) |
| Authorized Official Telephone | 9076312807 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 112983 | AK | Agencies |
| Street Address |
634 S BAILEY ST 106 |
| City | PALMER |
| State | AK |
| Zip Code | 99645-6360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164465712 | Jason Brooks | Family Medicine | 634 S Bailey St, Ste 104, Palmer, AK 99645-6330 | 2006-06-13 |
| 1508121096 | Borealis Behavioral Health | Marriage & Family Therapist | 634 S Bailey St, Suite 207, Palmer, AK 99645-6330 | 2012-07-10 |
| 1669754370 | William Kerst | Clinical Neuropsychologist | 634 S Bailey St, Ste 106, Palmer, AK 99645-6360 | 2011-09-20 |
| 1184771750 | Jana T Miner-collins | Marriage & Family Therapist | 634 S Bailey St, Suite 207, Palmer, AK 99645-6330 | 2007-01-04 |
| 1891842472 | Michael William Johndro | Marriage & Family Therapist | 634 S Bailey St, Suite 207, Palmer, AK 99645-6330 | 2007-01-04 |
| 1205992849 | Tracy L Freer | Registered Nurse | 634 S Bailey St, Suite 207, Palmer, AK 99645-6330 | 2006-12-28 |
| 1356368054 | Palmer Family Medicine Inc | Family Medicine | 634 S Bailey St, Suite 104, Palmer, AK 99645-6330 | 2006-07-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295357135 | Kasey M Flintoft | Occupational Therapist | 7200 E. Jim Cottrell Cir, Palmer, AK 99645 | 2020-05-14 |
| 1629601471 | Courtney Randol | Licensed Practical Nurse | 14405 E Pace Dr., Palmer, AK 99645 | 2020-02-20 |
| 1689213092 | Valerie Anne Delaune | Acupuncturist | 9693 N. Little Otter Dr., Palmer, AK 99645 | 2020-01-02 |
| 1003464512 | Alaskan Sunrise Behavioral Health, L.L.C. | Clinic/Center | 14460 E. Pace Dr., Palmer, AK 99645 | 2019-08-28 |
| 1548814718 | Maple Springs of Palmer Snf Holdings, LLC | Skilled Nursing Facility | 12130 E Maple Springs Way, Palmer, AK 99645 | 2019-07-26 |
| 1952868655 | Carla Beth Kelly | Physical Therapist | 7200 Jim Cottrell Circle, Palmer, AK 99645 | 2019-02-28 |
| 1366938375 | Wendy S Page | Behavior Technician | 7200 E Jim Cottrell, Wasilla, AK 99645 | 2018-07-03 |
| 1154845170 | Sarah Elizabeth Gilliland | Occupational Therapist | 7200 E Jim Cottrell Circle, Palmer, AK 99645 | 2017-08-01 |
| 1558885137 | Garland Brooks | Massage Therapist | 1934 Prospect Dr, Palmer, AK 99645 | 2017-07-26 |
| 1386165009 | Sommer Dawn Nielsen | Massage Therapist | 3566 N Mars Ave., Palmer, AK 99645 | 2017-07-03 |
| Find all providers in zip 99645 | ||||
| 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 |
|---|---|---|---|---|
| 1780026989 | Codi | Community/Behavioral Health | 7610 East Palmer-wasilla Hwy, Palmer, AK 99645 | 2013-07-29 |
| 1134767494 | Akeela Inc | Community/Behavioral Health | 561 S Denali St Ste F, Palmer, AK 99645-6464 | 2019-12-18 |
| 1205267473 | Codi, Inc. | Community/Behavioral Health | 11921 E Palmer Wasilla Hwy, Palmer, AK 99645-8833 | 2013-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1124646641 | Alaska Art Therapy and Counseling | Community/Behavioral Health | 1107 W 8th St Unit 5, Juneau, AK 99801-1853 | 2020-07-10 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1316561509 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1507 3rd St, Douglas, AK 99824 | 2020-06-03 |
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| Find all providers with the same taxonomy | ||||
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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.