COYOTE FAIRBANK LCSW
NPI 1447783170
Social Worker - Clinical in Polson, MT
- Individual
- Male
- Social Worker
- Clinical
- Accepts Insurance
- Opted-Out Medicare
About COYOTE FAIRBANK
This page provides the complete NPI Profile along with additional information for Coyote Fairbank, a provider established in Polson, Montana with a medical specialization in Social Worker, focusing in clinical . The healthcare provider is registered in the NPI registry with number 1447783170 assigned on April 2017. The practitioner's primary taxonomy code is 1041C0700X with license number BBH-LCSW-LIC-23635 (MT). The provider is registered as an individual and his NPI record was last updated 3 years ago.
- NPI
- 1447783170 Verify this NPI
- Provider Name
- COYOTE FAIRBANK LCSW
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 2 6TH AVE E POLSON, MT 59860
- Location Phone
- (406) 214-3137
- Mailing Address
- PO BOX 181 POLSON, MT 59860
- Mailing Phone
- (406) 214-3137
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 04-10-2017
- Last Update Date
- 11-27-2023
- Code Navigator
A clinical social worker like Coyote Fairbank is licensed to diagnose and treat mental, behavioral, and emotional disorders. A clinical social worker helps patients develop strategies to change behavior or cope with difficult situations and refer patients to other resources or services, such as support groups or other mental health professionals.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Coyote Fairbank opted out of Medicare effective on 07-01-2024 until 07-01-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Secondary Locations
- 1602 2nd St W
Polson, MT 59860
(406) 214-3137 - 7935 Mt Highway 35 Ste 202
Bigfork, MT 59911
(406) 214-3137
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Social Worker Clinical
- Taxonomy Code
- 1041C0700X
- Type
- Behavioral Health & Social Service Providers
- License No.
- BBH-LCSW-LIC-23635
- License State
- MT
- Taxonomy Description
- A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Focus Bronze POS? 205 - POS
- Blue Focus Bronze POS? 705 - POS
- Blue Focus Bronze POS? Standard - POS
- Blue Focus Gold POS? 207 - POS
- Blue Focus Gold POS? 902 - POS
- Blue Focus Gold POS? Standard - POS
- Blue Focus Silver POS? 206 - POS
- Blue Focus Silver POS? 903 - POS
- Blue Focus Silver POS? Standard - POS
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Core Standard Gold - EPO
- Core Standard Silver - EPO
- PacificSource Oregon Standard Bronze HSA Plan Core - EPO
- PacificSource Oregon Standard Gold Plan Core - EPO
- PacificSource Oregon Standard Silver Plan Core - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 07-01-2024
Opt-Out End Date: 07-01-2026
Eligible to Order and Refer? No
Reviews for COYOTE FAIRBANK LCSW
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Other Providers at the Same Location
The following 9 providers are registered at the same or a nearby location.
POLSON, MT 59860
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1447783170, enumerated as an "individual" on April 10, 2017.
The provider is located at 2 6TH AVE E POLSON, MT 59860 and the phone number is (406) 214-3137.
Social Worker with taxonomy code 1041C0700X and a focus in Clinical.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana and. Please consult your insurance carrier or call the provider to verify.
