Rebecca Christensen Fairbanks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8890207-3501 Issued in UT

Practice address

2020 S Lake St
Salt Lake City, UT 84105-3119

Phone

(801) 487-7778

Fax

(435) 652-6354

NPI assigned

Feb 20, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Rebecca Ann Christensen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Family Support Center

  • Mental Health Counselor
  • Salt Lake City, UT
  • NPI 1730473786
  NPD (past)
• Family Support Center

  • Mental Health Counselor
  • Taylorsville, UT
  • NPI 1912392762
  NPD (past)

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392854400000",
    "number": "1588089049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 W 4805 S",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841291177",
            "telephone_number": "801-955-9110",
            "fax_number": "801-955-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 S LAKE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053119",
            "telephone_number": "801-487-7778",
            "fax_number": "435-652-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "REBECCA",
        "middle_name": "CHRISTENSEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-20",
        "last_updated": "2014-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "8890207-3501",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "117144",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "REBECCA",
            "last_name": "CHRISTENSEN",
            "middle_name": "ANN",
            "credential": "LICSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Scott L Fahrner, MD
• Jared Faigle
• Jennica Lynne Failner
• Philip Fair
• Grant R Fairbanks, MD
• Spencer Fairbanks
• Brayden Fairbourn
• Fairbourne Group
• Kyle Fairchild, MS OTR/L
• Erica A. Faircloth, M.D., P.C.

• Clinical Social Worker in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Clinical Social Worker in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.