Active NPI
Fairbanks Community Mental Health Services, LLC
- Prescribing (Medical) Psychologist
- Fairbanks, AK
National Provider Identifier
1972987998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prescribing (Medical) Psychologist
- Legal business name
- FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC
- Practice address
- 3830 S Cushman St
Fairbanks, AK 99701-7530 - Phone
- (907) 371-1300
- Fax
- (907) 770-8917
- NPI assigned
- Jul 20, 2015
- Organization subpart
- Yes
- Parent organization
- ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Amy Morrow
- Title
- Billing Manager
- Phone
- (907) 762-2820
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prescribing (Medical) Psychologist | 103TP0016X | Primary | ||
| Rehabilitation Psychologist | 103TR0400X |
Addresses
Primary practice location
3830 S Cushman St
Fairbanks, AK 99701-7530
Mailing address
4020 Folker St
Anchorage, AK 99508-5321
Phone (907) 561-1000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| K165350 | Other | AK | MEDICARE |
National Provider Directory
National Provider Directory- Part of
- Anchorage Com Mental HL
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437350400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1437350400000",
"number": "1972987998",
"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": "907-561-1000",
"fax_number": "907-770-8917"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3830 S CUSHMAN ST",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997017530",
"telephone_number": "907-371-1300",
"fax_number": "907-770-8917"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAIRBANKS COMMUNITY MENTAL HEALTH SERVICES, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ANCHORAGE COMMUNITY MENTAL HEALTH SERVICES, INC",
"enumeration_date": "2015-07-20",
"last_updated": "2015-07-20",
"status": "A",
"authorized_official_last_name": "MORROW",
"authorized_official_first_name": "AMY",
"authorized_official_title_or_position": "BILLING MANAGER",
"authorized_official_telephone_number": "907-762-2820"
},
"taxonomies": [
{
"code": "103TP0016X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Prescribing (Medical)",
"state": null,
"license": null,
"primary": true
},
{
"code": "103TR0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Rehabilitation",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "K165350",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
- Fairbanks Community Imaging, LLC
- Fairbanks Community Mental Health Center
- Fairbanks Community Mental Health Services
- Fairbanks Community Mental Health Services, LLC
- Fairbanks Community Mental Health Services, LLC
- Fairbanks Counseling and Adoption
- Fairbanks Counseling Associates, LLC
- Fairbanks Dental Center LLC
- Fairbanks Dental Specialists, LLC
- Fairbanks Family Dental Care Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.