NPIMap

Organization Active NPI

Monarch Psychiatry of Alaska LLC

  • Adult Mental Health Clinic/Center
  • Anchorage, AK
National Provider Identifier
1891200911
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X
License
1062801 Issued in AK
Legal business name
MONARCH PSYCHIATRY OF ALASKA LLC
Practice address
101 W Benson Blvd Ste 306
Anchorage, AK 99503-3936
Phone
(907) 885-1089
Fax
(907) 885-1059
NPI assigned
Dec 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Authorized official

Name
Lucinda Miller-Mangrobang
Title
Member Manager
Phone
(907) 885-1089

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 576 AK
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 4965 AK
Adult Mental Health Clinic/Center 261QM0850X 1062801 AK Primary
Adolescent and Children Mental Health Clinic/Center 261QM0855X 1062801 AK
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 1364 AK

Addresses

Primary practice location

101 W Benson Blvd Ste 306
Anchorage, AK 99503-3936

Mailing address

101 W Benson Blvd Ste 306
Anchorage, AK 99503-3936
Phone (907) 885-1089

Other identifiers 2

IdentifierTypeStateIssuer
1679481MedicaidAK
615323OtherAKTRICARE HNFS GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

101 W Benson Blvd
Ste 306
Anchorage, AK 99503
Phone (907) 885-1089

4600 Debarr Rd
Ste 150
Anchorage, AK 99508

Practitioners & affiliated clinicians

Practitioners 12

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": "1513036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673827200000",
    "number": "1891200911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W BENSON BLVD STE 306",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033936",
            "telephone_number": "907-885-1089",
            "fax_number": "907-885-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W BENSON BLVD STE 306",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033936",
            "telephone_number": "907-885-1089",
            "fax_number": "907-885-1059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONARCH PSYCHIATRY OF ALASKA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-12",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A",
        "authorized_official_last_name": "MILLER-MANGROBANG",
        "authorized_official_first_name": "LUCINDA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "907-885-1089"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "576",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AK",
            "license": "4965",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "AK",
            "license": "1062801",
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "AK",
            "license": "1062801",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "1364",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679481",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE HNFS GROUP NUMBER",
            "identifier": "615323",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

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