John W Pendrey IV, CDCII, NCAC1
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Anchorage, AK
NPI 1164516597 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1164516597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 2212 (AK)
- Practice address
- 3001 C Street
Department of Veterans Affairs Domiciliary
Anchorage, AK 99503 - Phone
- (907) 273-4000
- Fax
- (907) 273-4085
- NPI assigned
- Oct 2, 2006
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2212 | AK | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2212 | AK | Yes |
Addresses
Primary practice location
3001 C Street
Department of Veterans Affairs Domiciliary
Anchorage, AK 99503
Mailing address
2620 Monmouth Avenue
Anchorage, AK 99502
Phone (907) 273-4088
Other providers in Anchorage, AK
- Krista Ann Pemberton
- Prentiss J Pemberton
- Karen L. Pena
- Joseph Marvin Penafort
- Ashley Kay Pendegrass
- Chandra Denee Penn
- David Penn
- Anna Penny
- Roger Paul Penrod
- Cornelio Pentecostes
All providers in Anchorage, 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 Jul 8, 2007. 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.