| Samara Fairwell, LADC, LPCC | |
|
11660 Round Lake Blvd Nw, Coon Rapids, MN 55433-2638 | |
| (844) 697-8766 | |
| Not Available |
| Full Name | Samara Fairwell |
|---|---|
| Gender | Female |
| Speciality | Mental Health Counselor |
| Experience | 3 Years |
| Location | 11660 Round Lake Blvd Nw, Coon Rapids, Minnesota |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770351918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 306766 (Minnesota) | Secondary |
| 101YP2500X | Counselor - Professional | 5428 (Minnesota) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Nystrom And Associates Ltd | 6406752492 | 590 |
| Entity Name | Nystrom & Associates Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592 |
| Mailing Address | Practice Location Address |
|---|---|
| Samara Fairwell, LADC, LPCC 1900 Silver Lake Rd Nw, New Brighton, MN 55112-1786 Ph: (866) 938-4159 | Samara Fairwell, LADC, LPCC 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433-2638 Ph: (844) 697-8766 |
Uzoma Chinyere Omeoga, MA, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 205 124th Ln Nw, Coon Rapids, MN 55448 Phone: 651-387-3702 |
Abigail Fletcher, Counselor Medicare: Accepting Medicare Assignments Practice Location: 3833 Coon Rapids Blvd Nw Ste 120, Coon Rapids, MN 55433 Phone: 763-767-3350 |
Sadichhya Shakya, Counselor Medicare: Medicare Enrolled Practice Location: 9120 Springbrook Dr Nw, Coon Rapids, MN 55433 Phone: 952-767-6791 |
Jessica K Wilbur, PSYD LP Counselor Medicare: Accepting Medicare Assignments Practice Location: 11850 Blackfoot St Nw Ste 405, Coon Rapids, MN 55433 Phone: 763-236-0888 |
Mrs. Nikisha Lynnette Simmons-maclin, LADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10026 University Ave Nw Ste 103, Coon Rapids, MN 55448 Phone: 612-636-9677 |
Adam Palowski, LPCC Counselor Medicare: Accepting Medicare Assignments Practice Location: 10077 Dogwood St Nw, Coon Rapids, MN 55448 Phone: 612-676-1604 |
Charles Lochner, MA Counselor Medicare: Accepting Medicare Assignments Practice Location: 11660 Round Lake Blvd Nw, Coon Rapids, MN 55433 Phone: 763-767-3350 Fax: 763-767-0912 |