Jeanine S Fair is a Clinical in Portage, Wisconsin. Jeanine S Fair practices all healthcare services and medical treatments related to Clinical. The NPI Number for Jeanine S Fair is 1174551774. The last update date is 2007-07-08.
Jeanine S Fair's current location address is 2901 Hunters Trl, Portage, Wisconsin. You can contact this provider via phone number 6087425518 and fax number 6087424087. The mailing address for Jeanine S Fair is 2901 Hunters Trl, Portage, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jeanine S Fair |
|---|---|
| Address | 2901 Hunters Trl, Portage, Wisconsin |
| Phone Number | 6087425518 |
| Fax Number | 6087424087 |
| Sole Proprietor | N |
| Credentials | MSW, CICS |
NPI Number Detail
| NPI Number | 1174551774 |
|---|---|
| Provider Enumeration Date | 2006-06-30 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2901 Hunters Trl |
|---|---|
| City | Portage |
| State | Wisconsin (WI) |
| Post Code | 539013403 |
| Phone Number | 6087425518 |
| Fax Number | 6087424087 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 3127-123 |
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Definition: 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, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 39688300 | WI | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Jeanine S Fair by the Centers for Medicare & Medicaid Services?
The Jeanine S Fair has been issued the NPI (National Provider Identifier) 1174551774, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Jeanine S Fair?
The Jeanine S Fair is physically situated at 2901 Hunters Trl, in the city of Portage, state of WI, with the postal code 539013403.
What is Jeanine S Fair's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Jeanine S Fair is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
When did Jeanine S Fair receive its 1174551774 assignment?
The Jeanine S Fair was assigned its 1174551774 on 2006-06-30, which is the date when this unique identifier was issued to the organization.
When was the information regarding Jeanine S Fair most recently updated?
The details pertaining to the Jeanine S Fair, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.