Dajia Fairman

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1202 Kirkman St Ste a
Lake Charles, LA 70601-5391

Phone

(337) 990-5305

Fax

(337) 990-5306

NPI assigned

Dec 5, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cognitive Development Center of Baton Rouge

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Baton Rouge, LA
  • NPI 1467745000
  NPD (past)

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

{
    "created_epoch": "1733356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1013723071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 KIRKMAN ST STE A",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015391",
            "telephone_number": "337-990-5305",
            "fax_number": "337-990-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 KIRKMAN ST STE A",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015391",
            "telephone_number": "337-990-5305",
            "fax_number": "337-990-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRMAN",
        "first_name": "DAJIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-05",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Quinn Ezernack
• Megan A Fabian, LPC
• Chad David Fairchild, M.D.
• Jude Paul Fairchild, D.D.S.
• Tammy Lynn Fairchild, MD
• Falgoust Eye Medical and Surgical
• Donald Charles Falgoust, MD
• Family and Youth Counseling Agency, Inc.
• Family Bridges Counseling Center, LLC
• Family Life Counseling Services, LLC

• Case Manager/Care Coordinator in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Case Manager/Care Coordinator in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.