NPIMap

Organization Active NPI

Fairman Psychological Services LLC

  • Clinical Psychologist
  • Joplin, MO
National Provider Identifier
1376821892
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2004033756 Issued in MO
Legal business name
FAIRMAN PSYCHOLOGICAL SERVICES LLC
Practice address
2722 S. Main St.
Suite a
Joplin, MO 64804
Phone
(417) 437-3244
NPI assigned
Aug 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Authorized official

Name
Dr. Jason Carter Fairman, PSY.D.
Title
Licensed Psychologist
Phone
(417) 437-3244

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 2004033756 MO Primary

Addresses

Primary practice location

2722 S. Main St.
Suite a
Joplin, MO 64804

Mailing address

2722 S. Main St.
Suite a
Joplin, MO 64804
Phone (417) 437-3244

National Provider Directory

National Provider Directory

Locations

18742 Highway 59
Ste 3
Neosho, MO 64850
Phone (417) 437-3244

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1376821892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 S. MAIN ST.",
            "address_2": "SUITE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-437-3244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2722 S. MAIN ST.",
            "address_2": "SUITE A",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "64804",
            "telephone_number": "417-437-3244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMAN PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "FAIRMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CARTER",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "417-437-3244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2004033756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.

Verify at the official NPI Registry.