Jovial Therapy Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

JOVIAL THERAPY SERVICES LLC

Practice address

43335 Kalifornsky Beach Rd BLD D, Ste C
Soldotna, AK 99669-8250

Phone

(907) 953-3257

Fax

(907) 802-6826

NPI assigned

Sep 25, 2023

Organization subpart

No

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

Authorized official

Name

Nicole Palacios, LCSWNPI 1962902437

Title

Provider / Owner

Phone

(907) 953-3257

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Tax ID family

Jovial Therapy Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jovial Therapy Services LLC

  • Community/Behavioral Health Agency
  • Soldotna, AK
  • NPI 1477332054
  NPD tax ID

Locations

Practitioners 1

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

• Nicole Isabell Palacios

  • Clinical Social Worker
  • Soldotna, AK
  • NPI 1962902437

  AK, Clinical

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1695600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1992584585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43335 KALIFRONSKY BEACH ROAD",
            "address_2": "BLD D STE C",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996699231",
            "telephone_number": "907-953-3257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43335 KALIFORNSKY BEACH RD BLD D, STE C",
            "city": "SOLDOTNA",
            "state": "AK",
            "postal_code": "996698250",
            "telephone_number": "907-953-3257",
            "fax_number": "907-802-6826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOVIAL THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-25",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A",
        "authorized_official_last_name": "PALACIOS",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PROVIDER / OWNER",
        "authorized_official_telephone_number": "907-953-3257",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kylie B Jones, FNP
• Abigail Jorgensen, DNP, FNP-BC
• Joseph J Mirci DMD
• Nicholas James Josten, M.D.
• Jovial Therapy Services LLC
• Jan Justice
• K-Beach Medical Inc.
• K-Beach Speech, LLC
• Sean D Kalagher, MD
• John Kamauoha

• All providers in Soldotna, AK
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.