NPIMap

Organization Active NPI

Maniilaq Association

  • Mental Health Counselor
  • Kotzebue, AK
National Provider Identifier
1699392258
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MANIILAQ ASSOCIATION
Practice address
733 2ND Ave
Kotzebue, AK 99752
Phone
(907) 442-7238
Fax
(907) 442-7403
NPI assigned
Jun 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Erin Jacobs
Title
Director of Patient Financial Servi
Phone
(907) 442-7238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

733 2ND Ave
Kotzebue, AK 99752

Mailing address

PO Box 43
Kotzebue, AK 99752-0043
Phone (907) 442-7238

Other identifiers 1

IdentifierTypeStateIssuer
1021015MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Buckland Clinic45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1593475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1699392258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "997520043",
            "telephone_number": "907-442-7238",
            "fax_number": "907-442-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "733 2ND AVE",
            "city": "KOTZEBUE",
            "state": "AK",
            "postal_code": "99752",
            "telephone_number": "907-442-7238",
            "fax_number": "907-442-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANIILAQ ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "JACOBS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "DIRECTOR OF PATIENT FINANCIAL SERVI",
        "authorized_official_telephone_number": "907-442-7238"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021015",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kotzebue, AK

Sources for this page

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