PAUL DOUGLAS FAIRBANKS NCC LCPC NPI 1356748578

NPI Information

NPI: 1356748578
Provider Name: PAUL DOUGLAS FAIRBANKS, NCC, LCPC
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

PECOS Registration: Yes

Address:
1047 CANNELL CT
ROCKTON, IL
ZIP 61072
Phone: (815) 566-0466
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Paul Douglas Fairbanks, NCC, LCPC is a professional counselor in Rockton, IL. Paul Douglas Fairbanks, NCC, LCPC NPI is 1356748578. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1047 CANNELL CT
ROCKTON, IL
ZIP 61072-596
Phone: (815) 566-0466

The NPI 1356748578 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 12/3/2014 and was last updated on 11/4/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	180011693	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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