Rebecca Michelle Fannin, CT, LCDC III

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

120 Twin Oaks Dr
Jackson, OH 45640-9506

Phone

(740) 570-3450

NPI assigned

May 18, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Integrated Services for Behavioral HealthGroup PAC ID 9234372525, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/isaoh/r4/

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

• Integrated Services for Behavioral Health

  • Clinical Social Worker
  • Nelsonville, OH
  • NPI 1073578431

  OH

  Medicare reassignment Care Compare group NPD
• Health Recovery Services, Inc

  • Mental Health Counselor
  • Athens, OH
  • NPI 1427024124

  Addiction (Substance Use Disorder)

  NPD (past)
• Health Recovery Services, Inc

  • Addiction (Substance Use Disorder) Counselor
  • Athens, OH
  • NPI 1881957587

  Addiction (Substance Use Disorder)

  NPD (past)
• Integrated Services for Behavioral Health

  • Community/Behavioral Health Agency
  • Nelsonville, OH
  • NPI 1205196201
  NPD (past)

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

{
    "created_epoch": "1495065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741219200000",
    "number": "1578090759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 COLUMBUS RD",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457011334",
            "telephone_number": "740-592-6724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TWIN OAKS DR",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456409506",
            "telephone_number": "740-570-3450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANNIN",
        "first_name": "REBECCA",
        "middle_name": "MICHELLE",
        "credential": "CT, LCDC III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-18",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578090759",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Jackson, OH
• Providers in Jackson, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 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.