Kurtis Hunt Fairbank, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

1205 Issued in MT

Practice address

100 Graves Creek Rd
Thompson Falls, MT 59873-9400

Phone

(406) 827-9853

NPI assigned

Jan 29, 2010

Last updated

Jan 29, 2010By 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 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Building Bridges

  • Addiction (Substance Use Disorder) Counselor
  • Thompson Falls, MT
  • NPI 1366702995
  NPD (past)

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1659602761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1310",
            "city": "THOMPSON FALLS",
            "state": "MT",
            "postal_code": "598731310",
            "telephone_number": "406-827-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GRAVES CREEK RD",
            "city": "THOMPSON FALLS",
            "state": "MT",
            "postal_code": "598739400",
            "telephone_number": "406-827-9853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANK",
        "first_name": "KURTIS",
        "middle_name": "HUNT",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Becky Sue Christensen, APRN
• Clark D Lundgren DC LLC (Lundgren Chiropractic & Wellness Clinic LLC)
• County of Sanders
• Lana Marie Dicken, LCSW
• Tristan Egelhoff
• Steven Fairbank, LAC, NCAC II
• Full Spectrum Psychotherapy Inc
• Gateway Community Services (Gateway Community Services-Thompson Falls)
• Gateway Community Services (Gateway Community Services-Thompson Falls)
• Roland Elwyn Goertzen, DDS

• Addiction (Substance Use Disorder) Counselor in Thompson Falls, MT
• Providers in Thompson Falls, MT by specialty
• Addiction (Substance Use Disorder) Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.