Fairchild, Nicole

Fairchild, Nicole is an individual health care provider with primary practice located at 600 School St Jasper School District, Jasper AR 72641-8802. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / School is her primary health care specialty. Fairchild, Nicole can be contacted via phone (870) 446-9305.

Contact Information

Primary practice address
600 School St Jasper School District Jasper AR 72641-8802
Phone: (870) 446-9305
Fax: (870) 446-6754
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2002031917 Missouri
Behavioral Health & Social Service Providers / School 101YS0200X P1011074 Arkansas

Profile Details

NPI number 1104824341
LBN Legal business name Fairchild, Nicole
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Apr 2nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104824341 NPPES
Missouri MEDICAID 497205401

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