Timothy Fairbanks, LISW is a
Social Worker - Clinical based in North Liberty, Iowa. Timothy Fairbanks is licensed to practice in Iowa (license number 081394) and his current practice location is
1290 Jordan St, North Liberty, Iowa. He can be reached at his office (for appointments etc.) via phone at
(319) 249-0307.
NPI number for Timothy Fairbanks is 1619693785 and his current mailing address is 1900 Silver Lake Rd Nw Ste 110, New Brighton, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1619693785.
Healthcare Provider's Profile
Full Name | Timothy Fairbanks |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 1290 Jordan St, North Liberty, Iowa |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1619693785
- Provider Enumeration Date: 10/19/2022
- Last Update Date: 10/17/2024
Medical Identifiers
Medical identifiers for Timothy Fairbanks such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619693785 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 081394 (Iowa) | Secondary |
1041C0700X | Social Worker - Clinical | 081394 (Iowa) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Timothy Fairbanks is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Timothy Fairbanks, LISW 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 Ph: (651) 628-9566 | Timothy Fairbanks, LISW 1290 Jordan St, North Liberty, IA 52317-8020 Ph: (319) 249-0307 |
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