Courtni Denise Fairbanks, MA-R

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

CG60803223 Issued in WA

Practice address

1014 Walla Walla Ave
Wenatchee, WA 98801-1523

Phone

(509) 663-0034

Fax

(509) 663-3726

NPI assigned

Dec 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Courtni Denise Fairbanks Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Children'S Home Society

  • Adolescent and Children Mental Health Clinic/Center
  • Wenatchee, WA
  • NPI 1376056796
  NPD (past)
• Children'S Home Society of Washington

  • Community/Behavioral Health Agency
  • Wenatchee, WA
  • NPI 1174601611
  NPD (past)

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1215442942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 WALLA WALLA AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011523",
            "telephone_number": "509-663-0034",
            "fax_number": "509-663-3726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 WALLA WALLA AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988011523",
            "telephone_number": "509-663-0034",
            "fax_number": "509-663-3726"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 Eastmont Ave Ste B220",
            "address_purpose": "LOCATION",
            "city": "East Wenatchee",
            "state": "WA",
            "postal_code": "988025306",
            "country_code": "US",
            "telephone_number": "509-885-9090",
            "fax_number": "509-884-0118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "COURTNI",
        "middle_name": "DENISE",
        "credential": "MA-R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-04",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "CG60803223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COURTNI",
            "last_name": "FAIRBANKS",
            "middle_name": "DENISE",
            "credential": "MA-R",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Eye and Ear Clinic of Wenatchee Inc PS
• Eye and Ear Clinic of Wenatchee Inc PS
• Martha Fadich
• Michael J. Fadich, M.D.
• Robert Snead Fain III, MD
• Miguel A Falcon, MSW
• Amanda Farias
• Briana Farmer, PA-C
• Rebekah Marie Farrington, L.M.P.
• Madeleine Kay Fast

• Mental Health Counselor in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.