Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

MS. Janice Lynn Fairbank, LPC, LIAC, SAP

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1255051298

MS. Janice Lynn Fairbank, LPC, LIAC, SAP is a Mental Health Counselor in Eagle, Idaho. Qualified in 2022, 4 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona, Idaho and New Mexico.

Years since qualifying
4
Licensed in
AZ, ID, NM
In the registry since
2022
Specialties on file
4
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

951 E Plaza Dr
Eagle, ID 83616-6566
Phone: (208) 938-2836
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence LCPC-8471063 (ID)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence LIAC-15597 (AZ)
Professional Counselor Taxonomy 101YP2500X · Licence LPC-23937 (AZ)
Professional Counselor Taxonomy 101YP2500X · Licence CTB-2026-0500 (NM)

Record details

NPI number1255051298
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC , LIAC , SAP
Sole proprietorYes
NPI enumeratedAugust 30, 2022
Last updated in NPPESJuly 27, 2026
Certification dateJuly 27, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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