Active NPI
Kristin J Fairey, MA LPCC
- Mental Health Counselor
- Albuquerque, NM
National Provider Identifier
1497997860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0100081
- Practice address
- 8205 Spain Rd NE
Suite 106
Albuquerque, NM 87109-3179 - Phone
- (505) 856-0300
- Fax
- (505) 856-7946
- NPI assigned
- Apr 1, 2009
- Last updated
- Feb 16, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 0113581 | NM | |
| Mental Health Counselor | 101YM0800X | 0100081 | NM | Primary |
Addresses
Primary practice location
8205 Spain Rd NE
Suite 106
Albuquerque, NM 87109-3179
Mailing address
8205 Spain Rd NE
Suite 106
Albuquerque, NM 87109-3179
Phone (505) 856-0300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48625225 | Medicaid | NM |
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 |
|---|---|---|---|
| 0113581 | NM | MD | Addiction (Substance Use Disorder) Counselor |
| 0100081 | NM | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487203200000",
"number": "1497997860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8205 SPAIN RD NE",
"address_2": "SUITE 106",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871093179",
"telephone_number": "505-856-0300",
"fax_number": "505-856-7946"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8205 SPAIN RD NE",
"address_2": "SUITE 106",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871093179",
"telephone_number": "505-856-0300",
"fax_number": "505-856-7946"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIREY",
"first_name": "KRISTIN",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "MA LPCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-01",
"last_updated": "2017-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NM",
"license": "0113581",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0100081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "48625225",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
- Jennifer Hope Failla, LPCC
- Eva Dennie Fain, RN CDE
- Vivian Lashawn Fain, LPCC
- Joanna Fair, M.D., PH. D.
- Isabel Faircloth, CRNA
- Jaymes Vincent Fairfax-Columbo, JD/PHD
- Faith & Grace Therapeutic Services
- Faith & Grace Therapeutic Services and Consultation (Faith & Grace Therapeutic Services)
- Faith and Hope Care
- Faith and Hope Care
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.