DR. TANISHA FAIRGOOD LMFT
NPI 1275957359
Marriage & Family Therapist in Roseville, CA

Q: What is Tanisha Fairgood's NPI number?

The NPI number for Tanisha Fairgood is 1275957359. It was assigned to this individual provider in the NPPES registry on February 10, 2014.

Q: What is Tanisha Fairgood's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: When was this NPI record last updated?

The NPPES record for Tanisha Fairgood was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 10, 2014PECOS Enrolled

1624 SANTA CLARA DR STE 145, ROSEVILLE, CA 95661(916) 206-8548 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 11, 2022, May 23, 2017 (2 updates tracked since 2017).

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About Dr. Tanisha Fairgood Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TANISHA FAIRGOOD LMFT (NPI 1275957359) is an individual marriage & family therapist in Roseville, California, licensed in California (99693) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275957359

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameDR. TANISHA FAIRGOODCredential: LMFT

Location Address1624 SANTA CLARA DR STE 145Roseville, CA 95661-3500

Mailing Address1624 Santa Clara Dr., Suite 145Roseville, CA 95661

Phone(916) 206-8548

Sole ProprietorYes

Enumeration DateFebruary 10, 2014

Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration

✔ NPI 1275957359 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Licenses✔ Licensed in CA · 99693✔ Licensed in CA · IMF69306

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

1624 SANTA CLARA DR STE 145, Roseville, CA 95661

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Tanisha Fairgood Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH MARIE MARTINEZ BEHAVIOR SPECIALIST

Case Manager/Care Coordinator