Stanley Ernie Heckman
Individual provider Active NPI Community Health Worker · Bethel, AK
NPI 1114190022 · NPPES record last updated Apr 2, 2015
Key facts
- NPI
- 1114190022
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 829 Chief Eddie Hoffman Hwy
Suite 150
Bethel, AK 99559 - Phone
- (907) 543-6100
- Fax
- (907) 543-6159
- NPI assigned
- Apr 11, 2008
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
829 Chief Eddie Hoffman Hwy
Suite 150
Bethel, AK 99559
Mailing address
PO Box 528
Attn: BH Village Services
Bethel, AK 99559-0528
Phone (907) 543-6100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1020986 | Medicaid | AK | |
| DA4442 | Medicaid | AK |
Other providers in Bethel, AK
- Phillip Haskins
- Bessie Hawk
- Deanna Heckman
- Lavonne Bridget Heckman
- Natalia Heckman
- Noah Hein
- Nicole Helmick
- Bertha A Henry
- David Scott Henry
- Jennifer Henry
All providers in Bethel, AK · Community Health Worker in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2015. 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.