Fairbanks Community Mental Health Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES

Practice address

926 Aspen St
Fairbanks, AK 99709-5501

Phone

(907) 371-1300

NPI assigned

Feb 3, 2021

Last updated

Feb 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ashley Evenson

Title

Billing Manager

Phone

(907) 261-5317

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Fairbanks Community Mental Health Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Fairbanks Community Mental Health Services, LLC

  • Professional Counselor
  • Fairbanks, AK
  • NPI 1396417325
  NPD tax ID

Locations

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612310400000",
    "number": "1790377588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4020 FOLKER ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085321",
            "telephone_number": "907-563-1000",
            "fax_number": "907-375-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "926 ASPEN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095501",
            "telephone_number": "907-371-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-03",
        "last_updated": "2021-02-03",
        "certification_date": "2021-02-03",
        "status": "A",
        "authorized_official_last_name": "EVENSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "907-261-5317"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1596091",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fairbanks Community Behavioral Health Center
• Fairbanks Community Behavioral Health Center
• Fairbanks Community Care Coordination
• Fairbanks Community Imaging, LLC
• Fairbanks Community Mental Health Center
• Fairbanks Community Mental Health Services, LLC
• Fairbanks Community Mental Health Services, LLC
• Fairbanks Community Mental Health Services, LLC
• Fairbanks Counseling and Adoption
• Fairbanks Counseling Associates, LLC

• Community/Behavioral Health Agency in Fairbanks, AK
• Providers in Fairbanks, AK by specialty
• Community/Behavioral Health Agency in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2021; 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.