Individual provider Active NPI

Beverly Ranken, PSYD

  • Psychologist
  • Juneau, AK
National Provider Identifier
1790230605
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
206221 Issued in AK
Practice address
225 Front St
Juneau, AK 99801-1244
Phone
(907) 364-4565
NPI assigned
Aug 20, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 206221 AK Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

225 Front St
Juneau, AK 99801-1244

Mailing address

3100 Channel Dr Ste 300
Juneau, AK 99801-7837

Other identifiers 2

IdentifierTypeStateIssuer
1747834MedicaidAK
206221OtherAKSTATE OF ALASKA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241205002164 TX Practitioner - Mental Health Counselor 4082140652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southeast Alaska Regional Health ConsortiumGroup PAC ID 1456265362, 373 clinicians

Practice addresses (Care Compare)

225 Front St
Juneau, AK 99801-1244
Phone (907) 966-2411

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 3, 2024 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Oct 3, 2024 Accepting new patients

Locations

225 Front St
Juneau, AK 99801
Phone (907) 364-4565

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1471651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1790230605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNEL DR STE 300",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 FRONT ST",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011244",
            "telephone_number": "907-364-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANKEN",
        "first_name": "BEVERLY",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-20",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AK",
            "license": "206221",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1747834",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF ALASKA",
            "identifier": "206221",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.