Barbara Jean Fairfax, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A11193 Issued in NC

Practice address

220 Ronnie CT Ste 2
Myrtle Beach, SC 29579-4192

Phone

(910) 880-0575

NPI assigned

May 11, 2015

Last updated

May 16, 2022By the provider in NPPES

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

Other names 1

• Ms. Barbara Hardee Williams Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1093193096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "583 OLD CARTRETTE RD",
            "city": "CLARENDON",
            "state": "NC",
            "postal_code": "284328819",
            "telephone_number": "910-880-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RONNIE CT STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794192",
            "telephone_number": "910-880-0575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRFAX",
        "first_name": "BARBARA",
        "middle_name": "JEAN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A11193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BARBARA",
            "last_name": "WILLIAMS",
            "middle_name": "HARDEE",
            "prefix": "MS.",
            "credential": "LPC-A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Mental Health Counselor in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.