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PAUL DOUGLAS FAIRBANKS LCPC / LPC
NPI 1356748578
Counselor - Mental Health in Rogersville, TN

Active since December 03, 2014PECOS Enrolled
1175 OLD HIGHWAY 66, ROGERSVILLE, TN 37857(815) 566-0466 Get Directions Write a Review

NPPES record last updated: January 30, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 30, 2026, May 26, 2025, Nov 4, 2021 (3 updates tracked since 2021).

About Paul Douglas Fairbanks Lcpc / Lpc NPPES

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

PAUL DOUGLAS FAIRBANKS LCPC / LPC (NPI 1356748578) is an individual mental health provider in Rogersville, Tennessee, licensed in Arizona (LPC-23438) and active in the NPI registry since December 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Gilbert.

NPPES Registry Identity

NPI1356748578
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NamePAUL DOUGLAS FAIRBANKSCredential: LCPC / LPC
Location Address1175 OLD HIGHWAY 66Rogersville, TN 37857-5175
Mailing Address1175 Old Highway 66Rogersville, TN 37857-5175 · (815) 566-0466
Phone(815) 566-0466
Sole ProprietorYes
Enumeration DateDecember 3, 2014
Last NPPES UpdateJanuary 30, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 30, 2026
✔ NPI 1356748578 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AZ · LPC-23438
Also ListedCounselor · ProfessionalTaxonomy 101YP2500X · License 180011693 (IL)
1175 OLD HIGHWAY 66, Rogersville, TN 37857
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Secondary Practice Location 1

Location 12200 E Williams Field Rd Ste 200Gilbert, AZ 85295-0764 · Phone (815) 566-0466

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna HealthCare of Arizona, Inc, Imperial Insurance Companies, Inc., Oscar Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Paul Douglas Fairbanks Lcpc / Lpc 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.

Medicare Billing Reassignments

4

Medicare enrollment records show Paul Fairbanks reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Illinois Post-Acute Medical Services 1 PC
462 mi
Hospitalist
15 SALT CREEK LN
Hinsdale, IL 60521
  • Reassigned Medicare billing, Illinois enrollment
  • 52 clinicians in this Medicare group
NPI 1952830853 (865) 693-1000
Nexumhc Consultants, PLLC
467 mi
Clinical
7040 N RIDGEWAY AVE STE 102
Lincolnwood, IL 60712
  • Reassigned Medicare billing, Illinois enrollment
  • 44 clinicians in this Medicare group
NPI 1851082598 (773) 945-1994
Cs Pacs 3 Il, S.C.
472 mi
Hospitalist
1001 N GREENWOOD AVE
Park Ridge, IL 60068
  • Reassigned Medicare billing, Illinois enrollment
  • 44 clinicians in this Medicare group
NPI 1598577124 (847) 692-5600
Jodi M Fourt
488 mi
Clinical
1530 N RANDALL RD STE 220
Elgin, IL 60123
  • Reassigned Medicare billing, Illinois enrollment
  • 2 clinicians in this Medicare group
NPI 1376235184 (224) 703-5595

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Fairbanks's NPI number?

The NPI number for Paul Fairbanks is 1356748578. It was assigned to this individual provider in the NPPES registry on December 3, 2014.

Where is Paul Fairbanks located?

Paul Fairbanks practices at 1175 Old Highway 66, Rogersville, TN 37857. The listed phone number is (815) 566-0466.

What is Paul Fairbanks's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Paul Fairbanks enrolled in Medicare?

Yes. Paul Fairbanks is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Paul Fairbanks's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Fairbanks reassigns Medicare benefits to 4 organizations: Illinois Post-Acute Medical Services 1 PC (Hinsdale, IL), Nexumhc Consultants, PLLC (Lincolnwood, IL), Cs Pacs 3 Il, S.C. (Park Ridge, IL) and Jodi M Fourt (Elgin, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Paul Fairbanks's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Fairbanks accept?

Health plans from Cigna HealthCare of Arizona, Inc, Imperial Insurance Companies, Inc., Oscar Health, Quartz and UnitedHealthcare list Paul Fairbanks as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Paul Fairbanks was last updated on January 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.