Gloria A Benson, CDC 1

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Yakutat, AK

NPI 1396249496 · NPPES record last updated Mar 22, 2018

Key facts

NPI
1396249496
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
4226 (AK)
Practice address
712 Ocean Cape Rd
Yakutat, AK 99689
Phone
(907) 784-3275
Fax
(907) 784-3263
NPI assigned
Mar 22, 2018
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
Yakutat Community Health Center Past
since Sep 25, 2022
Accepting new patients
Yakutat Tribal Health Board Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4226 AK Yes

Addresses

Primary practice location

712 Ocean Cape Rd
Yakutat, AK 99689

Mailing address

PO Box 112
Yakutat, AK 99689-0112
Phone (907) 784-3275

Other providers in Yakutat, AK

All providers in Yakutat, AK · Addiction (Substance Use Disorder) Counselor in Alaska

Sources for this page

Verify at the official NPI Registry.