Timothy Fairbanks, LISW
NPI 1619693785ActiveIndividual· Social Worker, Clinical· North Liberty, IA
Social Worker, Clinical (LISW) with Psychiatric Associates of Iowa, PC, practicing in North Liberty, Iowa. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1619693785 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LISW |
| Sole proprietor | No |
| NPI issued | Oct 19, 2022 |
| Last updated in NPPES | Oct 17, 2024 |
| Certified by provider | Oct 17, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | 081394 | IA |
| Counselor, Mental Health | 101YM0800X | 081394 | IA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (IA) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Psychiatric Associates of Iowa, PCNorth Liberty, IA · 47 clinicians
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