Brooke Ann Avila

Individual provider Active NPI Mental Health Counselor · Ketchikan, AK

NPI 1164026977 · NPPES record last updated Nov 23, 2020

Key facts

NPI
1164026977
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
2524 First Ave
Ketchikan, AK 99901-5804
Phone
(907) 617-6145
Fax
(907) 885-6613
NPI assigned
Nov 23, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Youth & Community (Ryc) Current
since Nov 29, 2020
Accepting new patients
Resilient Youth & Community (Ryc) Current
since Jun 1, 2025
Accepting new patients

Locations

2524 First Ave
Ketchikan, AK 99901
Phone (907) 202-8752

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/rycalaska/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X AK Yes

Addresses

Primary practice location

2524 First Ave
Ketchikan, AK 99901-5804

Mailing address

PO Box 7475
Ketchikan, AK 99901-2475
Phone (907) 617-6145

Other identifiers

IdentifierTypeStateIssuer
1584706MedicaidAK
1021118MedicaidAK

Other names

  • Ms. Brooke Ann Nanez Other name

Other providers in Ketchikan, AK

All providers in Ketchikan, AK · Mental Health Counselor in Alaska

Sources for this page

Verify at the official NPI Registry.