Active NPI
Sean-Michael Richard Dunham, BA PSYCH.
- Mental Health Counselor
- Fairbanks, AK
National Provider Identifier
1841500592
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3830 S. Cushman Street
Fairbanks, AK 99701 - Phone
- (907) 455-5304
- Fax
- (907) 455-1460
- NPI assigned
- Oct 15, 2010
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
3830 S. Cushman Street
Fairbanks, AK 99701
Mailing address
3290 Helen Place
Fairbanks, AK 99709
Phone (907) 455-6567
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH0157 | Medicaid | AK |
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
- Credentials
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330041600000",
"number": "1841500592",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3290 HELEN PLACE",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99709",
"telephone_number": "907-455-6567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 S. CUSHMAN STREET",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "99701",
"telephone_number": "907-455-5304",
"fax_number": "907-455-1460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUNHAM",
"first_name": "SEAN-MICHAEL",
"middle_name": "RICHARD",
"credential": "BA PSYCH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-15",
"last_updated": "2012-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MH0157",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.