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

Timothy Fairbanks, LISW

Individual provider Mental Health Counselor · NPI 1619693785

Timothy Fairbanks, LISW is a Clinical Social Worker in North Liberty, Iowa. Qualified in 2016, 10 years ago. Practices with Psychiatric Associates of Iowa, PC, a 54-clinician group and accepts Medicare assignment. Licensed in Iowa.

Years since qualifying
10
Licensed in
IA
In the registry since
2022
Specialties on file
2
What do these letters mean?
LISW — Licensed Independent Social Worker
A social worker licensed to practise independently.

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Practice location Address checks out

1290 Jordan St
North Liberty, IA 52317-8020
Phone: (319) 249-0307
Fax: (319) 358-2367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 081394 (IA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 081394 (IA)

Record details

NPI number1619693785
Entity typeIndividual (Type 1)
GenderMale
Credentials LISW
Sole proprietorNo
NPI enumeratedOctober 19, 2022
Last updated in NPPESOctober 17, 2024
Certification dateOctober 17, 2024

Medicare enrollment

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

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Psychiatric Associates Of Iowa, Pc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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