Organization Active NPI

Hope Holders Ketchikan

  • Mental Health Counselor
  • Ketchikan, AK
National Provider Identifier
1245919794
Registry record updated Dec 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HOPE HOLDERS KETCHIKAN
Practice address
3175 Jackson Heights St
Ketchikan, AK 99901-5782
Phone
(907) 617-1378
NPI assigned
Jul 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2023

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

Authorized official

Name
Mr. John David Sundeen, LPC
Title
Executive Clinical Director
Phone
(907) 821-4674

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Peer SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 175T00000X

Addresses

Primary practice location

3175 Jackson Heights St
Ketchikan, AK 99901-5782

Mailing address

3175 Jackson Heights St
Ketchikan, AK 99901-5782
Phone (907) 617-1378

Other names 1

  • Hope Holders Alaska Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1689120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703894400000",
    "number": "1245919794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3175 JACKSON HEIGHTS ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015782",
            "telephone_number": "907-617-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3175 JACKSON HEIGHTS ST",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015782",
            "telephone_number": "907-617-1378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOPE HOLDERS KETCHIKAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-12",
        "last_updated": "2023-12-30",
        "certification_date": "2023-12-30",
        "status": "A",
        "authorized_official_last_name": "SUNDEEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "EXECUTIVE CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "907-821-4674",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hope Holders Alaska",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Hope Holders Alaska",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2023; 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.