Individual provider Active NPI

Jeff Joseph Fauque, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Great Falls, MT
National Provider Identifier
1972936227
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
810410694 Issued in MT
Practice address
920 4TH Ave N
Great Falls, MT 59401-1514
Phone
(406) 727-8892
Fax
(406) 727-8172
NPI assigned
Aug 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 810410694 MT Primary

Addresses

Primary practice location

920 4TH Ave N
Great Falls, MT 59401-1514

Mailing address

920 4TH Ave N
Great Falls, MT 59401-1514
Phone (406) 727-8892

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Treatment Center Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376006400000",
    "number": "1972936227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 4TH AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594011514",
            "telephone_number": "406-727-8892",
            "fax_number": "406-727-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 4TH AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594011514",
            "telephone_number": "406-727-8892",
            "fax_number": "406-727-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUQUE",
        "first_name": "JEFF",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "810410694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.