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LUCIUS FAIRBOTHAM SPECIALIST
NPI 1497350516
Specialist in Kalamazoo, MI

Active since December 04, 2020
610 S BURDICK ST, KALAMAZOO, MI 49007(269) 381-3700(269) 381-3700 Get Directions Write a Review

NPPES record last updated: December 4, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Lucius Fairbotham Specialist NPPES

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

LUCIUS FAIRBOTHAM SPECIALIST (NPI 1497350516) is an individual specialist in Kalamazoo, Michigan and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1497350516
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameLUCIUS FAIRBOTHAMCredential: SPECIALIST
Location Address610 S BURDICK STKalamazoo, MI 49007-5221
Mailing Address610 S Burdick StKalamazoo, MI 49007-5221 · (269) 381-3700 · Fax (269) 381-3700
Phone(269) 381-3700
Fax(269) 381-3700
Sole ProprietorNo
Enumeration DateDecember 4, 2020
NPPES CertifiedDecember 4, 2020
✔ NPI 1497350516 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
610 S BURDICK ST, Kalamazoo, MI 49007
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Other Providers at the Same Location NPPES 20

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

TINA EGAN CPSS
Peer Specialist
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700
CHRIS DALE CPSS
Peer Specialist
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700
MARSHALL HLATKO RN
Registered Nurse (Psychiatric/Mental Health, Adult)
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700
JUDE SULLIVAN CAMPBELL LLMSW
Social Worker (Clinical)
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 373-6000
RUDOLPH P VERBOS
Social Worker
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 373-6000
ANGELA MESSINGER
Peer Specialist
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700
JACLYN REID LLMSW
Social Worker (Clinical)
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700
MADELINE SCHELL BS
Student in an Organized Health Care Education/Training Program
610 S BURDICK ST
KALAMAZOO, MI 49007
Kalamazoo County (269) 381-3700

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 Lucius Fairbotham's NPI number?

The NPI number for Lucius Fairbotham is 1497350516. It was assigned to this individual provider in the NPPES registry on December 4, 2020.

Where is Lucius Fairbotham located?

Lucius Fairbotham practices at 610 S Burdick St, Kalamazoo, MI 49007. The listed phone number is (269) 381-3700.

What is Lucius Fairbotham's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Lucius Fairbotham was last updated on December 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.