Zachary Fannin

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

300170 Issued in KY

Practice address

12 E 5TH St
Newport, KY 41071-1618

Phone

(859) 578-3200

Fax

(859) 534-2627

NPI assigned

Aug 16, 2020

Last updated

Aug 27, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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 BoardGroup PAC ID 3870584683, 45 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Northern Kentucky Mental Health Mental Retardation Regional Board

  dba NorthKey Community Care

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Covington, KY
  • NPI 1578527610
  Medicare reassignment Care Compare group NPD
• Northern Kentucky Mental Health Mental Retardation Regional Board

  dba Northkey Community Care

  • Psychiatric Hospital
  • Covington, KY
  • NPI 1679775514
  NPD

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

{
    "created_epoch": "1597536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756252800000",
    "number": "1568073146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 EDALBERT DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452397604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 E 5TH ST",
            "city": "NEWPORT",
            "state": "KY",
            "postal_code": "410711618",
            "telephone_number": "859-578-3200",
            "fax_number": "859-534-2627"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5400 Edalbert Dr",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452397604",
            "country_code": "US",
            "telephone_number": "513-741-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FANNIN",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-16",
        "last_updated": "2025-08-27",
        "certification_date": "2025-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "300170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Newport, KY
• Providers in Newport, KY by specialty
• Mental Health Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.