Glenn Jacob Fairhurst

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

BBHPCLCLIC70082 Issued in MT

Practice address

33 Division Rd Unit 1
Great Falls, MT 59404-1410

Phone

(406) 781-2074

NPI assigned

Jan 30, 2024

Sex

Male

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Affirming Hope Counseling LLC

  • Mental Health Counselor
  • Great Falls, MT
  • NPI 1659134799
  NPD Authorized official

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

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1982467361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DIVISION RD UNIT 1",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041410",
            "telephone_number": "406-781-2074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 DIVISION RD UNIT 1",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041410",
            "telephone_number": "406-781-2074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRHURST",
        "first_name": "GLENN",
        "middle_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-30",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBHPCLCLIC70082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evergreen Independant Living, LLC
• Marjorie Geisz Everson, CRNA
• Eye Clinic of Great Falls, P.C.
• Eye Mart Express LLC
• Eyemart Express LTD
• Kevin Jon Fairhurst, DMD
• Falls Family Pastoral Counseling Center
• Falls Forward Coaching LLC
• Falls Neuropsychological Services, P.C.
• Family Birth Center, LLC

• Mental Health Counselor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Mental Health Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.