Individual provider Active NPI

Linda Fares, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Lapeer, MI
National Provider Identifier
1417512302
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704353173 Issued in MI
Practice address
1257 N Main St
Lapeer, MI 48446-1346
Phone
(810) 882-1458
Fax
(754) 218-0872
NPI assigned
May 6, 2019
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 209031277 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209031277 IL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704353173 OH
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704353173 MI Primary
Family Nurse Practitioner 363LF0000X 4704353173 MI
Family Nurse Practitioner 363LF0000X APRN.CNP.0033763 OH

Addresses

Primary practice location

1257 N Main St
Lapeer, MI 48446-1346

Mailing address

1257 N Main St
Lapeer, MI 48446-1346
Phone (810) 882-1458

Other practice location 1

3000 Corporate Exchange Dr
Columbus, OH 43231-7689
Phone (888) 562-5442

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, NM, OH, FL, MA, IL6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20211130000856 MI Practitioner - Nurse Practitioner 8123418597 Reassigns benefits to 2 organizations
I20230509000009 NM Practitioner - Nurse Practitioner 8123418597 Reassigns benefits to 1 organization
I20230517001562 OH Practitioner - Nurse Practitioner 8123418597 Reassigns benefits to 1 organization
I20241108000781 FL Practitioner - Nurse Practitioner 8123418597 Reassigns benefits to 1 organization
I20241219003327 MA Practitioner - Nurse Practitioner 8123418597 Reassigns benefits to 1 organization
I20250219001083 IL Practitioner - Nurse Practitioner 8123418597

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704353173MIMDFamily Nurse Practitioner
4704353173OHMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Healthcare of California CurrentSince Oct 8, 2024 Accepting new patients
Promind LLC Nurse Practitioner CurrentSince Oct 25, 2025 Accepting new patients
Universal Care CurrentSince Oct 8, 2024 Accepting new patients
Central Health Plan of California, Inc. CurrentSince Oct 8, 2024 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

1257 N Main St
Lapeer, MI 48446
Phone (810) 664-4526

Interoperability endpoints

  • Direct secure messaging: lfares736246@direct.hfhs.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1417512302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1257 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461346",
            "telephone_number": "810-882-1458",
            "fax_number": "754-218-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1257 N MAIN ST",
            "city": "LAPEER",
            "state": "MI",
            "postal_code": "484461346",
            "telephone_number": "810-882-1458",
            "fax_number": "754-218-0872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 Corporate Exchange Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432317689",
            "country_code": "US",
            "telephone_number": "888-562-5442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARES",
        "first_name": "LINDA",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209031277",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209031277",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OH",
            "license": "4704353173",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704353173",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704353173",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0033763",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lapeer, MI

Sources for this page

Verify at the official NPI Registry.