Active NPI
Ebony Nicole Fails, MA, LPC
- Counselor
- Ann Arbor, MI
National Provider Identifier
1922776780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 6401017673
- Practice address
- 3131 S State St Ste 226
Ann Arbor, MI 48108-1658 - Phone
- (800) 693-1916
- NPI assigned
- Sep 5, 2021
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401017673 | MI | Primary |
Addresses
Primary practice location
3131 S State St Ste 226
Ann Arbor, MI 48108-1658
Mailing address
PO Box 970633
Ypsilanti, MI 48197-0085
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401017673 | MI | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641600000000",
"number": "1922776780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 970633",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481970085"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 S STATE ST STE 226",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481081658",
"telephone_number": "800-693-1916"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAILS",
"first_name": "EBONY",
"middle_name": "NICOLE",
"credential": "MA, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-05",
"last_updated": "2022-01-08",
"certification_date": "2022-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MI",
"license": "6401017673",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.