NPIMap

Organization Active NPI

Petersburg Mental Health Services

  • Social Worker
  • Petersburg, AK
National Provider Identifier
1922443969
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
1224 Issued in AK
Legal business name
PETERSBURG MENTAL HEALTH SERVICES
Practice address
201 North Nordic Drive
Petersburg, AK 99833
Phone
(907) 772-3332
NPI assigned
May 3, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Authorized official

Name
Stephanie Anita Rodriguez, MSW
Title
Behavioral Health Clinician
Phone
(907) 772-3332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 104100000X 1224 AK Primary

Addresses

Primary practice location

201 North Nordic Drive
Petersburg, AK 99833

Mailing address

P.O. Box 1309
Petersburg, AK 99833
Phone (907) 772-3332

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1922443969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1309",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "99833",
            "telephone_number": "907-772-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NORTH NORDIC DRIVE",
            "city": "PETERSBURG",
            "state": "AK",
            "postal_code": "99833",
            "telephone_number": "907-772-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSBURG MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "BEHAVIORAL HEALTH CLINICIAN",
        "authorized_official_telephone_number": "907-772-3332",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": "AK",
            "license": "1224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.