NPIMap

Organization Active NPI

Life Anchor Counseling LLC

  • Clinical Social Worker
  • Derby, KS
National Provider Identifier
1013604891
Registry record updated Dec 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIFE ANCHOR COUNSELING LLC
Practice address
402 N River St Ste 200
Derby, KS 67037-1539
Phone
(316) 409-0565
NPI assigned
Apr 20, 2023
Last updated
Dec 16, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2025

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

Authorized official

Name
Indy FairbanksNPI 1013267756
Title
Owner
Phone
(316) 633-3262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

402 N River St Ste 200
Derby, KS 67037-1539

Mailing address

215 E 9TH Ave
Belle Plaine, KS 67013-8823
Phone (316) 633-3262

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765843200000",
    "number": "1013604891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 9TH AVE",
            "city": "BELLE PLAINE",
            "state": "KS",
            "postal_code": "670138823",
            "telephone_number": "316-633-3262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N RIVER ST STE 200",
            "city": "DERBY",
            "state": "KS",
            "postal_code": "670371539",
            "telephone_number": "316-409-0565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ANCHOR COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A",
        "authorized_official_last_name": "FAIRBANKS",
        "authorized_official_first_name": "INDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "316-633-3262"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Derby, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.