Shirley Ketah, MS, CDC1

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

4099 Issued in AK

Practice address

121 W Fireweed LN
Anchorage, AK 99503-2053

Phone

(907) 865-9653

NPI assigned

Jan 31, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1033617444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11408 HERITAGE CT APT 7",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995777778",
            "telephone_number": "907-854-6997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 W FIREWEED LN",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032053",
            "telephone_number": "907-865-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETAH",
        "first_name": "SHIRLEY",
        "name_prefix": "Ms.",
        "credential": "MS, CDC1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NH",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AK",
            "license": "4099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn L Kerris, OT
• Dennis Michael Keslar
• Kenneth Kesler, M.D.
• Kolleen Kessler Ellingboe, MHS
• Dianna Kessler, CST,FA
• Katy Violet Ketchum Smith, M.S.C.P.
• Linden Jane Ketchum, BA
• Corey Kettering
• Ashley Kettler, O.D.
• Ketz Chiropractic LLC

• Addiction (Substance Use Disorder) Counselor in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Addiction (Substance Use Disorder) Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.