Kimberly Fairchild, LPC in Wautoma, WI - Medicare Counselor Provider

Kimberly Fairchild, LPC is a medicare enrolled "Counselor - Mental Health" provider in Wautoma, Wisconsin. Her current practice location is 400 S Townline Rd, Wautoma, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 787-5514.

Kimberly Fairchild is licensed to practice in Wisconsin (license number 7129-125) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225424286.

Contact Information

	Kimberly Fairchild, LPC
	400 S Townline Rd, Wautoma, WI 54982-6922
	(920) 787-5514
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kimberly Fairchild
Gender	Female
Speciality	Counselor - Mental Health
Location	400 S Townline Rd, Wautoma, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225424286
Provider Enumeration Date: 04/07/2015
Last Update Date: 06/23/2025

Medicare PECOS Information:

PECOS PAC ID: 5294186243
Enrollment ID: I20240104000502

Medical Identifiers

Medical identifiers for Kimberly Fairchild such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225424286	NPI	-	NPPES
100043623	Medicaid	WI
K401235342	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
101YM0800X	Counselor - Mental Health	7129-125 (Wisconsin)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kimberly Fairchild allows following entities to bill medicare on her behalf.

Entity Name	La Clinica De Los Campesinos, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790786929 PECOS PAC ID: 8729996574 Enrollment ID: O20040806000058

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Fairchild is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Kimberly Fairchild, LPC 1472 16th Ave, Arkdale, WI 54613-9624 Ph: (920) 889-9388	Kimberly Fairchild, LPC 400 S Townline Rd, Wautoma, WI 54982-6922 Ph: (920) 787-5514

Reviews and Comments

Counselor in Wautoma, WI

Debra Jodarski, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: N4107 13th Ln, Wautoma, WI 54982 Phone: 920-787-2725
Mr. Patrick Isenberger, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550
Andrea Lee Behnke, APSW, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Ms. Bethany J Walker, APSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 380 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Mr. Paul Francis Theyel, CICSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 Park St, Wautoma, WI 54982 Phone: 920-787-6550 Fax: 920-787-0421
Veronica Eckstein, CSAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 400 S Townline Rd, Wautoma, WI 54982 Phone: 920-787-5514 Fax: 920-787-4737

Kimberly Fairchild, LPC - Medicare Counselor in Wautoma, WI