Allyson Fairchild, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH20614 Issued in FL

Practice address

9030 58TH Dr E Ste 103
Bradenton, FL 34202-6108

Phone

(941) 567-5207

Fax

(888) 769-9093

NPI assigned

Oct 17, 2022

Last updated

Oct 17, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Apr 1, 2025 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Envision Counseling Services

  • Mental Health Counselor
  • Lakewood Ranch, FL
  • NPI 1629323423
  NPD (past)

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1982320362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E STE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-567-5207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9030 58TH DR E STE 103",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342026108",
            "telephone_number": "941-567-5207",
            "fax_number": "888-769-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCHILD",
        "first_name": "ALLYSON",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH20614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sharon Fahey, LCSW
• Yasmin Medhat Ahmed Fahmi Eid Aboutaleb, MD
• Edmund Fahoury, MD
• Karen Sue Fain, LMT
• Kaitlyn Bassett Faipler, D.C.
• Faithful Friends Inc.
• Faithful Friends Loving Care Assisted Living Corporation
• Estela Fajardo
• Joseph S Fakih, PTA
• Alejandra J Falcon, RBT

• Mental Health Counselor in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.