Active NPI
Pamela Nicole Fairbrother, CSC-AD
- Addiction (Substance Use Disorder) Counselor
- Pasadena, MD
National Provider Identifier
1265050819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- SC2624
- Practice address
- 2528 Mountain Rd
Pasadena, MD 21122-7203 - Phone
- (443) 548-3733
- Fax
- (410) 360-1675
- NPI assigned
- Jul 9, 2020
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | SC2624 | MD | Primary |
Addresses
Primary practice location
2528 Mountain Rd
Pasadena, MD 21122-7203
Mailing address
2528 Mountain Rd
Pasadena, MD 21122-7203
Phone (443) 548-3733
Other practice location 1
4231 Postal Ct Ste 201
Pasadena, MD 21122-4474
Phone (443) 548-3733
Other practice location 2
5710 Ritchie Hwy
Brooklyn Park, MD 21225-3641
Phone (410) 636-5600
Other names 1
- Pamela Matthew
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SC2624 | MD | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1265050819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2528 MOUNTAIN RD",
"city": "PASADENA",
"state": "MD",
"postal_code": "211227203",
"telephone_number": "443-548-3733",
"fax_number": "410-360-1675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2528 MOUNTAIN RD",
"city": "PASADENA",
"state": "MD",
"postal_code": "211227203",
"telephone_number": "443-548-3733",
"fax_number": "410-360-1675"
}
],
"practiceLocations": [
{
"address_1": "4231 Postal Ct Ste 201",
"address_purpose": "LOCATION",
"city": "Pasadena",
"state": "MD",
"postal_code": "211224474",
"country_code": "US",
"telephone_number": "443-548-3733",
"fax_number": "410-360-1675",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5710 Ritchie Hwy",
"address_purpose": "LOCATION",
"city": "Brooklyn Park",
"state": "MD",
"postal_code": "212253641",
"country_code": "US",
"telephone_number": "410-636-5600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAIRBROTHER",
"first_name": "PAMELA",
"middle_name": "NICOLE",
"credential": "CSC-AD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MD",
"license": "SC2624",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "PAMELA",
"last_name": "MATTHEW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pasadena, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.