Telebehavioral Medicine Associates Inc.

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

TELEBEHAVIORAL MEDICINE ASSOCIATES INC.

Practice address

Telebehavioral Services
Willow, AK 99688-0522

Phone

(907) 715-7391

Fax

(907) 495-1283

NPI assigned

Sep 14, 2020

Last updated

Sep 16, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Herbert Schwager, PH.D

Title

Director

Phone

(907) 715-7391

Specialties & licenses 5

Addresses

Tax ID family

Alaska Telemedicine Consultants Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Alaska Telemedicine Consultants Inc

  dba Tele-Behavioral Medicine Associates

  • Psychologist
  • Willow, AK
  • NPI 1811502859
  NPD tax ID

Locations

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1265047518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 522",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "996880522",
            "telephone_number": "907-715-7391",
            "fax_number": "907-495-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "TELEBEHAVIORAL SERVICES",
            "city": "WILLOW",
            "state": "AK",
            "postal_code": "996880522",
            "telephone_number": "907-715-7391",
            "fax_number": "907-495-1283"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N Beeline Hwy # 134",
            "address_purpose": "LOCATION",
            "city": "Payson",
            "state": "AZ",
            "postal_code": "855414907",
            "country_code": "US",
            "telephone_number": "928-474-6617",
            "fax_number": "928-474-7059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TELEBEHAVIORAL MEDICINE ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "SCHWAGER",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "907-715-7391",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandria Camille Palmer
• Lisa Rene Schooler-Nuss
• Sunshine Community Health Center Inc
• Sunshine Community Health Center, Inc (Sunshine Communith Health Willow Dental Clinic)
• Sunshine Community Health Center, Inc. (Sunshine Community Health Center Pharmacy - Willow)
• Upper Su Valley Care Coordination
• Willow Creek Assisted Living
• Willow Personal Care Assistants, LLC
• Virginia N Wodkowski

• Adult Mental Health Clinic/Center in Willow, AK
• Providers in Willow, AK by specialty
• Adult Mental Health Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.