DAMON J PEMBERTON (NPI# 1679875819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679875819 |
| Entity Type | Individual |
| Full Name | DAMON J PEMBERTON |
| Credential | LCSW |
| Practice Address |
1407 W 31st Ave Ste, 400 Anchorage AK 99503-3678 |
| Practice Telephone | 9077710536 |
| Practice Fax Number | 9077710537 |
| Mailing Telephone | 9077710536 |
| Mailing Fax Number | 9077710537 |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
1011 | AK | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MH005 | 05 | |
| AK | MH5973 | 05 |
| Street Address |
1407 W 31ST AVE STE, 400 |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99503-3678 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871697342 | Cynthia Allen Ebelacker | Registered Nurse | 1407 W 31st Ave, Suite 201, Anchorage, AK 99503-3678 | 2006-09-12 |
| 1114275369 | Dana B Brokofsky | Counselor | 1407 W 31st Ave, Ste. 400, Anchorage, AK 99503-3678 | 2012-08-20 |
| 1801174586 | Family Diabetes Clinic | Clinical Nurse Specialist | 1407 W 31st Ave, Ste. 600, Anchorage, AK 99503-3678 | 2011-07-28 |
| 1649571142 | Seeganna Psychiatric Services | Nurse Practitioner | 1407 W 31st Ave, Ste. 201d, Anchorage, AK 99503-3678 | 2010-11-15 |
| 1073847943 | Cynthia Ebelacker, Anp | Nurse Practitioner | 1407 W 31st Ave, Ste 201, Anchorage, AK 99503-3678 | 2009-09-25 |
| 1700028727 | Anne Marie Zack, Anp,co,apc | Nurse Practitioner | 1407 W 31st Ave, Ste.201, Anchorage, AK 99503-3678 | 2009-04-06 |
| 1821258815 | Bruce Nairn Smith | Psychologist | 1407 W 31st Ave, Suite 602, Anchorage, AK 99503-3678 | 2008-06-12 |
| 1477743532 | Greatland Mental Health, LLC | Counselor | 1407 W 31st Ave, Ste 201, Anchorage, AK 99503-3678 | 2007-07-25 |
| 1467674333 | Anne Marie Zack | Nurse Practitioner | 1407 W 31st Ave, Suite 301, Anchorage, AK 99503-3624 | 2007-05-02 |
| 1801925599 | Susan Lagrande | Psychologist | 1407 W 31st Ave, Suite 602, Anchorage, AK 99503-3624 | 2007-03-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020772 | Miladis Mcduffie | Massage Therapist | 1350 W. Northern Lights Blvd, Ste C, Anchorage, AK 99503 | 2020-10-15 |
| 1447804984 | Bethany Lynn Becker | Optometrist | 401 E. Northern Lights Blvd. Suite 102, Anchorage, AK 99503 | 2019-08-01 |
| 1265084933 | Carr-gottstein Foods Co | Durable Medical Equipment & Medical Supplies | 2920 Seward Hwy, Anchorage, AK 99503 | 2019-07-12 |
| 1982268942 | Rukiyia Smith | Behavior Technician | 205 E Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-25 |
| 1245894310 | Mary Kathleen Tate | Specialist/Technologist | 205 E. Northern Lights Blvd, Suite 110, Anchorage, AK 99503 | 2019-04-24 |
| 1194295766 | Kimberly Sue Trent | Registered Nurse | 670 W. Fireweed Lane Suite 160, Anchorage, AK 99503 | 2018-11-27 |
| 1659869089 | Alaska Spine & Pain Center, LLC | Chiropractor | 3901 Old Seward Hwy Ste 11, Anchorage, AK 99503 | 2018-05-01 |
| 1235643123 | Rosanne Louise Klouda | Massage Therapist | 213 Fireweed Ln, Anchorage, AK 99503 | 2017-11-30 |
| 1801309042 | Online Care Group Alaska | General Practice | 200 W. 34th Ave, Anchorage, AK 99503 | 2017-11-09 |
| 1548773849 | Leslie K Michalski | Massage Therapist | 510 W Tudor Rd Ste 9, Anchorage, AK 99503 | 2017-11-08 |
| Find all providers in zip 99503 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760029391 | Nancy Lockwood | Social Worker | 731 E 8th Ave, Anchorage, AK 99501-3772 | 2019-12-02 |
| 1487298873 | Dan Bigley | Social Worker | 8531 Craiger Ct, Anchorage, AK 99507-3640 | 2019-10-29 |
| 1134782774 | Daniel Gladden II | Social Worker | 360 W Benson Blvd Ste 300, Anchorage, AK 99503-3953 | 2019-04-18 |
| 1245723824 | Pemberton&young LLC | Social Worker | 2600 Denali St Ste 430, Anchorage, AK 99503-2754 | 2018-06-08 |
| 1295280857 | Margie Rygh | Social Worker | 4300 B St Ste 106, Anchorage, AK 99503-5933 | 2016-08-23 |
| 1902254980 | Pamela Miller | Social Worker | 380 E 11th Ave Unit 326, Anchorage, AK 99501-6518 | 2016-05-31 |
| 1639530447 | Pamela Mildred Jones | Social Worker | 13210 Old Seward Hwy, #17, Anchorage, AK 99515-4052 | 2016-03-08 |
| 1114399623 | Ruddy Taylor | Social Worker | 5391 Caribou Ave, Anchorage, AK 99508-2560 | 2015-10-22 |
| 1881064533 | Lejla Berberovic | Social Worker | 4320 Diplomacy Dr Ste 1500, Anchorage, AK 99508-5925 | 2015-10-06 |
| 1427437466 | Jennifer Flanagan | Social Worker | 110 W 15th Ave Ste A, Anchorage, AK 99501-5106 | 2015-05-22 |
| 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.