Dr Fairall and Associates Behavioral Health and Family Mediation Servi

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 7675 Issued in FL

Legal business name

DR FAIRALL AND ASSOCIATES BEHAVIORAL HEALTH AND FAMILY MEDIATION SERVI

Practice address

4400 Marsh Landing Blvd
Suite 1
Ponte Vedra Beach, FL 32082-7215

Phone

(904) 463-2284

NPI assigned

Nov 30, 2015

Last updated

Nov 30, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Laurie Fairall, PSY.D.

Title

Owner

Phone

(904) 463-2284

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Laurie S. Fairall-Rueter, PSY.D.

  • Psychologist
  • Ponte Vedra Beach, FL
  • NPI 1487768248
  NPD (past)

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

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448841600000",
    "number": "1083088165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 OLD MILL CT",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320824133",
            "telephone_number": "904-463-2284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 MARSH LANDING BLVD",
            "address_2": "SUITE 1",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320827215",
            "telephone_number": "904-463-2284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR FAIRALL AND ASSOCIATES BEHAVIORAL HEALTH AND FAMILY MEDIATION SERVI",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A",
        "authorized_official_last_name": "FAIRALL",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-463-2284",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 7675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Distefano, FNP-BC
• Sarah Marie Dodds, OTR/L
• Emma Dorsett, PT, DPT
• Alisha Dionne Dowdy, CCC-SLP
• Carisa Nicole Doxzon, MS CCC-SLP
• Dr Nicole Winter LLC
• Dr. Kelly J. Huber, Inc (Chiropractic PLUS)
• Dr. Laurie Fairall-Rueter, LLC
• DRS. Wood, Lanier & Bowman, PA
• Andrew Thien Duong

• Psychologist in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.