Active NPI
Elise S Fair, MA, LPC
- Professional Counselor
- Greeley, CO
National Provider Identifier
1316936578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3797
- Practice address
- 2624 18TH Ave
Greeley, CO 80631-4024 - Phone
- (970) 674-3155
- NPI assigned
- Oct 19, 2005
- Last updated
- Apr 5, 2013
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3797 | CO | Primary |
Addresses
Primary practice location
2624 18TH Ave
Greeley, CO 80631-4024
Mailing address
2624 18TH Ave
Greeley, CO 80631-8111
Phone (970) 352-6120
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 |
|---|---|---|---|
| 3797 | CO | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1365120000000",
"number": "1316936578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2624 18TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806318111",
"telephone_number": "970-352-6120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2624 18TH AVE",
"city": "GREELEY",
"state": "CO",
"postal_code": "806314024",
"telephone_number": "970-674-3155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "ELISE",
"middle_name": "S",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-19",
"last_updated": "2013-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CO",
"license": "3797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greeley, CO
- Eyewear Center, Inc (greeley eyecare center)
- Chuk-Davis Obinna Ezeli
- Face Down Medical Equipment, LLC
- Kathleen Rose Fahey, PH.D., CCC-ALP
- Herbert Daniel Fahrenholtz, MD
- Fairacres Manor, Inc (Fairacres Manor)
- Fairacres Manor, Inc (Fairacres Manor)
- Sandra L Fairbanks, MA
- Brittany Fairchild, BSW
- Family Dental and Specialists of Greeley (Associates in Family Dentistry and Specialists of Greely)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.