Zachary Fannin
Individual provider Active NPI Mental Health Counselor · Newport, KY
NPI 1568073146 · NPPES record last updated Aug 27, 2025
Key facts
- NPI
- 1568073146
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 300170 (KY)
- Practice address
- 12 E 5TH St
Newport, KY 41071-1618 - Phone
- (859) 578-3200
- Fax
- (859) 534-2627
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Northern Kentucky Mental Health Mental Retardation Regional Board
Practice addresses (Care Compare)
12 E 5TH St
Newport, KY 41071-1618
Phone (859) 578-3200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250909003743 | KY | Practitioner - Mental Health Counselor | 1951804764 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300170 | KY | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northern Kentucky Mental Health Mental Retardation Regional Board | Current |
Accepting new patients | |
| Northern Kentucky Mental Health Mental Retardation Regional Board | Current |
Accepting new patients |
Locations
503 Farrell Dr
Covington, KY 41011
Phone (606) 578-3214
12 E 5th St
Newport, KY 41071
Phone (859) 491-6510
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Mental Health Counselor | 101YM0800X | 300170 | KY | Yes |
Addresses
Primary practice location
12 E 5TH St
Newport, KY 41071-1618
Mailing address
5400 Edalbert Dr
Cincinnati, OH 45239-7604
Other practice location 1
5400 Edalbert Dr
Cincinnati, OH 45239-7604
Phone (513) 741-3100
Other providers in Newport, KY
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- Javier A Felipe-Morales
- Jason Michael Feltner
- Brittany Nicole Fields
- Kurt Fields
- Alisa M Fisher
All providers in Newport, KY · Mental Health Counselor in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.