Amos Banham
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Palmer, AK
NPI 1033877873 · NPPES record last updated Aug 16, 2024
Key facts
- NPI
- 1033877873
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- Practice address
- 950 S Snodgrass Dr
Palmer, AK 99645-9750 - Phone
- (907) 373-4732
- Fax
- (907) 746-4749
- NPI assigned
- Nov 29, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AK | Yes |
Addresses
Primary practice location
950 S Snodgrass Dr
Palmer, AK 99645-9750
Mailing address
PO Box 876741
Wasilla, AK 99687-6741
Phone (907) 373-4732
Other providers in Palmer, AK
- Naidene Baechler
- Ashley Elisabeth Bailey
- Clara Marie Bailey
- Collette Azure Bailey
- Damion H Bailey
- Waymond Darnell Banks II
- Leigh Ann Barker
- Emily Barkley
- Meghan Barnett Sonnabend
- Kaitlyn Marie Barnett
All providers in Palmer, AK · Addiction (Substance Use Disorder) Counselor in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 16, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.