Healthcare Provider Details

I. General information

NPI: 1437273000
Provider Name (Legal Business Name): COOK INLET TRIBAL COUNCIL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 SAN JERONIMO DRIVE
ANCHORAGE AK
99508-2869
US

IV. Provider business mailing address

3600 SAN JERONIMO DRIVE
ANCHORAGE AK
99508-2869
US

V. Phone/Fax

Practice location:
  • Phone: 907-793-3600
  • Fax: 907-793-3250
Mailing address:
  • Phone: 907-793-3600
  • Fax: 907-793-3250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number88201
License Number StateAK
# 5
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number88201
License Number StateAK

VIII. Authorized Official

Name: MRS. GLORIA O'NEILL
Title or Position: PRESIDENT CEO
Credential:
Phone: 907-793-3600