| Michelle Fairbank, Llc | |
|
2703 Hall St Ste 13 Hays KS 67601-1964 | |
| (785) 261-0694 | |
| (785) 261-0697 |
| Full Name | Michelle Fairbank, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2703 Hall St Ste 13, Hays, Kansas |
| Authorized Official Name and Position | Michelle Fairbank (MENTAL HEALTH PROVIDER) |
| Authorized Official Contact | 7852610694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Fairbank, Llc 2703 Hall St Ste 13 Hays KS 67601-1964 Ph: (785) 261-0694 | Michelle Fairbank, Llc 2703 Hall St Ste 13 Hays KS 67601-1964 Ph: (785) 261-0694 |
| NPI Number | 1760239354 |
|---|---|
| Provider Enumeration Date | 05/02/2024 |
| Last Update Date | 05/02/2024 |
| Certification Date | 05/02/2024 |
| Medicare PECOS PAC ID | 4587003041 |
|---|---|
| Medicare Enrollment ID | O20240416003793 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760239354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michelle Fairbank |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1982045613 PECOS PAC ID: 3476994393 Enrollment ID: I20240509002215 |
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