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NPI Code Detail

MEDICARE: KALEIGH FAIRBAIRN

MEDICARE:   KALEIGH  FAIRBAIRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1114883006
Entity Type Code : Individual
Provider Name (Legal Business Name) : KALEIGH FAIRBAIRN
Provider Business Mailing Address
First Line : PO BOX 1056
Second Line :
City : SALEM
State : MA
Zip : 01970-6156
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 199 ROSEWOOD DR STE 300
Second Line :
City : DANVERS
State : MA
Zip : 01923-1388
Country : US
Telephone Number : 978-494-8163
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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Directions to “ KALEIGH FAIRBAIRN ” Practice Location

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