Marcia Anne Fairbanks, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904011395 Issued in VA

Practice address

500 Pegasus CT
Winchester, VA 22602-4596

Phone

(540) 313-4699

NPI assigned

Jun 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Carpe Diem Counseling

  • Clinical Social Worker
  • Winchester, VA
  • NPI 1578204442
  Medicare reassignment NPD
• Crossroads Treatment Center of Winchester, PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Winchester, VA
  • NPI 1750823043
  NPD
• Cacapon Counseling Services

  • Mental Health Counselor
  • Winchester, VA
  • NPI 1467068122
  NPD (past)
• Hava Oaks Medical, LLC

  • Behavioral Neurology & Neuropsychiatry Physician
  • Berryville, VA
  • NPI 1972268753
  NPD (past)

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1992437008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 PEGASUS CT",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024596",
            "telephone_number": "540-313-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PEGASUS CT",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226024596",
            "telephone_number": "540-313-4699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "MARCIA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904011395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mfairbanks@ctc.care",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "500 Pegasus Ct",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226024596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Evergreen SNF Operations LLC
• Tina W Eversole, ED.S.
• Emma Pitcock Everson, OTR/L
• Katie Everson, OTD, OTR/L
• Eye Associates of Winchester Inc.
• Su Fairchild, MD
• Olivia Fakhry
• Slavka B Falls, CRNA
• Anna Famiglietti
• Family Foot and Ankle Care, PC

• Clinical Social Worker in Winchester, VA
• Providers in Winchester, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.