Lori R Fairbairn, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

684-228 Issued in WI

Practice address

1177 Quail CT Ste 101
Pewaukee, WI 53072-3768

Phone

(262) 696-9809

NPI assigned

Nov 27, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1637971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637971200000",
    "number": "1366109290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1177 QUAIL CT STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723768",
            "telephone_number": "262-696-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1177 QUAIL CT STE 101",
            "city": "PEWAUKEE",
            "state": "WI",
            "postal_code": "530723768",
            "telephone_number": "262-696-9809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 Bishops Way Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530056221",
            "country_code": "US",
            "telephone_number": "262-696-9809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRBAIRN",
        "first_name": "LORI",
        "middle_name": "R",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-27",
        "last_updated": "2021-11-27",
        "certification_date": "2021-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "684-228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Pewaukee, WI
• Providers in Pewaukee, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2021; 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.