LACAGE MARIE HENDERSON (NPI# 1982266326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982266326 |
| Entity Type | Individual |
| Full Name | LACAGE MARIE HENDERSON |
| Practice Address |
2521 E Mountain Village Dr Ste F Wasilla AK 99654-7373 |
| Mailing Address |
3860 S Tradewinds Cir Wasilla AK 99623-9410 |
| Practice Telephone | 9072903760 |
| Practice Fax Number | 9076310647 |
| Mailing Telephone | 8109867053 |
| Enumeration Date | 2019-07-06 |
| Last Update Date | 2019-07-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
2521 E MOUNTAIN VILLAGE DR STE F |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-7373 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659722114 | Community Medical Services Montana-private, LLC | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654 | 2016-06-27 |
| 1144872151 | Jovan Kidder Aila | Case Manager/Care Coordinator | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-10 |
| 1780246082 | Kara Jane Holbrook | Licensed Practical Nurse | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| 1013579317 | Camille Machea Johnson | Registered Nurse | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| 1760044077 | Barbara Johnson-tow | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654-7373 | 2019-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1689239782 | Kristine Ione Bayne | Counselor | 2651 N. Thordore Dr, Wasilla, AK 99623 | 2019-05-03 |
| 1619531217 | Antiqua Lisha Libbey | Counselor | 4821 S Outrigger Dr., Wasilla, AK 99687 | 2019-04-29 |
| 1225691025 | Rebecca Browning | Counselor | 26731 W Point Mackenzie Rd, Wasilla, AK 99623-8709 | 2019-04-17 |
| 1659722114 | Community Medical Services Montana-private, LLC | Counselor | 2521 E Mountain Village Dr Ste F, Wasilla, AK 99654 | 2016-06-27 |
| 1891112488 | Paul Bossart | Counselor | 1810 S Redwing Cir, Wasilla, AK 99654-9744 | 2014-03-21 |
| 1124321989 | Douglas Edward Smith | Counselor | 5431 E Mayflower Ln, Suite 5, Wasilla, AK 99654-7891 | 2010-12-16 |
| 1407170269 | Clifton Young IIi | Counselor | 701 E Parks Hwy Ste 203, Wasilla, AK 99654-8162 | 2010-03-23 |
| 1225268832 | Olive Tree Counseling, Inc. | Counselor | 5730 E Pilgrim Court, Suite A, Wasilla, AK 99654 | 2009-07-16 |
| 1285872317 | Rae Ann Hendrickson | Counselor | 5730 E Pilgrim Ct, Suite A, Wasilla, AK 99654-7824 | 2009-01-28 |
| Find all providers in WASILLA | ||||
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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.