Healthcare Provider Details

I. General information

NPI: 1447199096
Provider Name (Legal Business Name): MR. DYLAN JAMES FAIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 SW HARRISON ST
TOPEKA KS
66611-2492
US

IV. Provider business mailing address

2409 CHAROLAIS LN
MANHATTAN KS
66502-6640
US

V. Phone/Fax

Practice location:
  • Phone: 785-266-4100
  • Fax:
Mailing address:
  • Phone: 785-410-9330
  • Fax: 785-410-9330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: