Provider Demographics
NPI:1386200467
Name:KEARSE, JAMES A (BHT II)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:A
Last Name:KEARSE
Suffix:
Gender:M
Credentials:BHT II
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:ALFONSO
Other - Last Name:KEARSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BHT II
Mailing Address - Street 1:4000 SAN ERNESTO AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:907-729-5020
Mailing Address - Fax:
Practice Address - Street 1:4000 SAN ERNESTO AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:907-729-5020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-14
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician