Organization · Type 2 NPI

Southcentral Foundation

Mental Health Clinic/Center (Including Community Mental Health Center) · Anchorage, AK

NPI number 1124064894 Active

Practice location

4320 Diplomacy Dr Ste 1500
Anchorage, AK 99508-5925

Call (907) 729-2500 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Specialties and licenses

Taxonomy	Code	License
Mental Health Counselor	101YM0800X	20467 (AK)
Mental Health Counselor	101YM0800X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	20467 (AK)

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

10 other providers at this address

Other mental health clinic/center (including community mental health center) providers in Anchorage

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NPI record

NPI: 1124064894
Entity type: Organization (Type 2)
Issued: Jun 21, 2006
Last updated: Aug 31, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

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Bsd-Anpcc Burt · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President Finance
(907) 729-4939

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1124064894

Southcentral Foundation's National Provider Identifier is 1124064894, issued on Jun 21, 2006. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Anchorage, AK. The record was last updated on Aug 31, 2023.