Active NPI
Allaina Terice Fair, LLBSW
- Mental Health Counselor
- Southgate, MI
National Provider Identifier
1710239488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 680285581
- Practice address
- 14799 Dix Toledo Rd
Southgate, MI 48195-2507 - Phone
- (734) 324-8326
- Fax
- (734) 324-8327
- NPI assigned
- Oct 5, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 680285581 | MI | Primary |
Addresses
Primary practice location
14799 Dix Toledo Rd
Southgate, MI 48195-2507
Mailing address
15645 Dupage Blvd
Taylor, MI 48180-6025
Phone (734) 657-6316
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 680285581 | MI | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349395200000",
"number": "1710239488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15645 DUPAGE BLVD",
"city": "TAYLOR",
"state": "MI",
"postal_code": "481806025",
"telephone_number": "734-657-6316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14799 DIX TOLEDO RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "481952507",
"telephone_number": "734-324-8326",
"fax_number": "734-324-8327"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAIR",
"first_name": "ALLAINA",
"middle_name": "TERICE",
"name_prefix": "Mrs.",
"credential": "LLBSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-05",
"last_updated": "2012-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MI",
"license": "680285581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.