Fairbanks Community Mental Health Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC

Practice address

3830 S Cushman St
Fairbanks, AK 99701-7530

Phone

(907) 452-1575

Fax

(907) 455-5287

NPI assigned

Oct 10, 2013

Organization subpart

Yes

Parent organization

ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Ms. Darcie M Shaffer, BAS, CPC

Title

Medical Billing Manager

Phone

(907) 563-1000

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• FCMHS Other name

Part of

Anchorage Com Mental HL

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

{
    "created_epoch": "1381363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1023445871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 PEGER RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095169",
            "telephone_number": "907-371-1300",
            "fax_number": "907-371-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017530",
            "telephone_number": "907-452-1575",
            "fax_number": "907-455-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC.",
        "enumeration_date": "2013-10-10",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "DARCIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL BILLING MANAGER",
        "authorized_official_telephone_number": "907-563-1000",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BAS, CPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1596091",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCMHS",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "FCMHS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Fairbanks Community Mental Health Center
• Fairbanks Community Mental Health Services
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• Fairbanks Counseling and Adoption
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• Fairbanks Dental Center LLC

• Community/Behavioral Health Agency in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.