Active NPI
Sandra L Fairbanks, MA
- Counselor
- Greeley, CO
National Provider Identifier
1124411368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPCC.0014194
- Practice address
- 928 12TH St
Greeley, CO 80631-4024 - Phone
- (970) 347-2120
- NPI assigned
- Mar 12, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPCC.0014194 | CO | Primary |
Addresses
Primary practice location
928 12TH St
Greeley, CO 80631-4024
Mailing address
1300 N 17TH Ave
Greeley, CO 80631-9584
Phone (970) 347-2120
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC.0014194 | CO | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426118400000",
"number": "1124411368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N 17TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806319584",
"telephone_number": "970-347-2120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 12TH ST",
"city": "GREELEY",
"state": "CO",
"postal_code": "806314024",
"telephone_number": "970-347-2120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIRBANKS",
"first_name": "SANDRA",
"middle_name": "L",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-12",
"last_updated": "2015-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "LPCC.0014194",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.