Providence Kodiak Island Counseling Center

NPI #1376141929 in Kodiak, Alaska

Provider Information

NPI Number
1376141929
Entity Type
Organization
Organization Name
Providence Kodiak Island Counseling Center
Primary Specialty
Community/Behavioral Health
Enumeration Date
Oct 15, 2020
Last Updated
May 15, 2025

Practice Location

Address
717 E REZANOF DR
City
Kodiak
State
Alaska
ZIP Code
99615-6416
Phone
(907) 481-2400

Authorized Official

Name
DONALD W ANDERSON JR.
Title
ASSISTANT SECRETARY OF ENROLLMENTS
Phone
(425) 358-9786

Specialties & Taxonomy Codes

Specialty
Community/Behavioral Health

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