MEDICARE: DIANE FAHY COUNSELING INC, PC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1720919103
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DIANE FAHY COUNSELING INC, PC

Provider Business Mailing Address
First Line	:	5075 MT HIGHWAY 35
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-8283
Country	:	US
Telephone Number	:	919-247-4703
Fax Number	:

Provider Business Practice Location Address
First Line	:	5075 MT HIGHWAY 35
Second Line	:
City	:	KALISPELL
State	:	MT
Zip	:	59901-8283
Country	:	US
Telephone Number	:	919-247-4703
Fax Number	:

Authorized Official
Title or Position	:	PRACTITIONER
Name	:	DIANE K FAHY
Credential	:	M.ED, LCMHC, NBCC
Telephone Number	:	919-247-4703

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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