PATRICK CLARK (NPI# 1770018459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770018459 |
| Entity Type | Individual |
| Full Name | PATRICK CLARK |
| Practice Address |
4020 Folker St Anchorage AK 99508-5321 |
| Practice Telephone | 9075631000 |
| Mailing Telephone | 9075631000 |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2017-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106S00000X | Behavior Technician | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164048591 | Patrick Alan Clark | Optometrist | 202 N Mitchell St, Rio Grande City, TX 78582-2509 | 2020-06-22 |
| 1548668346 | Patrick Nikita Clark | Non-emergency Medical Transport (VAN) | 4281 Durango Ln, Memphis, TN 38109-4721 | 2014-12-09 |
| 1235313388 | Patrick Jeremiah Clark | Social Worker | 540 E First St, Waconia, MN 55387-1601 | 2007-12-26 |
| 1598751588 | Patrick A Clark | Family Medicine | 9631 269th St Nw, Stanwood, WA 98292-8071 | 2005-09-23 |
| 1336508092 | Patrick J Clark | Dentist | 554 Kelly Street, Bumed, Attn: Credentialing & Privileging Directorate, Jacksonville, FL 32212 | 2016-02-23 |
| 1386941755 | Patrick Andrew Clark | Counselor | 9445 Farnham St, San Diego, CA 92123-1308 | 2011-02-22 |
| 1407036841 | Patrick W. Clark | Anesthesiology | 1800 Medical Center Pkwy, Suite 330, Murfreesboro, TN 37129-2567 | 2007-11-13 |
| 1972609436 | Patrick Timothy Clark | Physician Assistant | 4020 Us Highway 27 N, Sebring, FL 33870-1333 | 2006-09-15 |
| 1558301242 | Patrick Clark | Chiropractor | 1600 W 38th St, Suite 412, Austin, TX 78731-6407 | 2006-06-08 |
| 1285699553 | Patrick James Clark Jr. | Optometrist | 101 Bodin Cir, 60 Mdg/amds Optometry Clinic, Travis Afb, CA 94535-1809 | 2006-04-19 |
| Street Address |
4020 FOLKER ST |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134173172 | Anchorage Community Mental Health | Clinic/Center | 4020 Folker St, Anchorage, AK 99508-5321 | 2006-05-22 |
| 1962003822 | Jenna Laine Moretz | Technician, Pathology | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-11-05 |
| 1487254926 | Luke Bradley Offord | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-10-26 |
| 1053918268 | Christopher Michael Hindman | Registered Nurse | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-10-01 |
| 1346857158 | Tatiana Faletoi | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-09-25 |
| 1770199903 | Garreth Edwin | Behavior Technician | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-09-22 |
| 1922614320 | Linda Setterberg | Behavior Technician | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-09-21 |
| 1104431667 | Noryln L Aquino | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-09-11 |
| 1326652223 | Yannick Hodgin | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-09-08 |
| 1891305488 | Alisha Rukovishnikoff | Counselor | 4020 Folker St, Anchorage, AK 99508-5321 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 106S00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Behavior Technician |
| The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state (such as through licensure). The behavior technician is primarily responsible for the implementation of components of behavior-analytic treatment plans developed by the supervisor. That may include collecting data on treatment targets and conducting certain types of behavioral assessments (e.g., stimulus preference assessments). The behavior technician does not design treatment or assessment plans or procedures but provides services as assigned by the supervisor responsible for his or her work. |
| Notes: Association of Professional Behavior Analysts, www.apbahome.net and Behavior Analyst Certification Board (http://www.bacb.com) [7/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801422142 | Jacqueline Tarner | Behavior Technician | 13030 Brandon St, Anchorage, AK 99515-3536 | 2020-03-18 |
| 1134770035 | Samantha Jones | Behavior Technician | 1153 E 72nd Ave, Anchorage, AK 99518-2369 | 2019-09-23 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1316509805 | Kelly J Ross | Behavior Technician | 3819 Remington Cir, Anchorage, AK 99507-2888 | 2019-07-03 |
| 1033770672 | Kathy Eileen Mailelle | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-25 |
| 1669038493 | Sharone Elaine Thornton | Behavior Technician | 8731 Flamingo Dr, Anchorage, AK 99502-5423 | 2019-05-16 |
| 1306402789 | Benjamin Fielder | Behavior Technician | 6045 E 43rd Ave, Anchorage, AK 99504-4322 | 2019-05-11 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| 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.