Janice Lynn Fairbank, LPC, LIAC, SAP, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LCPC-8471063 Issued in ID

Practice address

8343 Willowpark Dr
Garden City, ID 83714-1676

Phone

(954) 366-9978

NPI assigned

Aug 30, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mental Health Specialty Group PA

  dba Rula Health

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  AZ

  Medicare reassignment Care Compare group NPD
• Integrative Psychotherapy and Assessment Services

  • Psychologist
  • Phoenix, AZ
  • NPI 1699146910
  Medicare reassignment NPD

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1255051298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8343 WILLOWPARK DR",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141676",
            "telephone_number": "602-488-7417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8343 WILLOWPARK DR",
            "city": "GARDEN CITY",
            "state": "ID",
            "postal_code": "837141676",
            "telephone_number": "954-366-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANK",
        "first_name": "JANICE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LPC, LIAC, SAP, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NM",
            "license": "CTB-2026-0500",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "AZ",
            "license": "LIAC-15597",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCPC-8471063",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-90419",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHC.LH.70013113",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-23937",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Direct Connect Idaho LLC (Mobility Mart Plus)
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• Mary Elizabeth Egbert-Hiner, RBT
• Sarah Kristina Erickson, LMSW
• Kevin Eubanks, PT, DPT
• Daniele Fallon, OTR
• Kyara Jayde Finney, DC
• Rachel Ford, LPC
• Fred Meyer Stores Inc (Fred Meyer Pharmacy)
• Freedom Senior Care, LLC (Amada Senior Care)

• Mental Health Counselor in Garden City, ID
• Providers in Garden City, ID by specialty
• Mental Health Counselor in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.