Individual
JOSEPH DWAYNE FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC
Contact information
Practice address
330 25TH ST, ASHLAND, KY 41101-7820
(606) 329-8588
Mailing address
PO BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
103514
KS
101YP2500X
Professional Counselor
Primary
103514
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12708338
CAQH
—
05
—
7100280980
—
KY
Enumeration date
04/18/2011
Last updated
08/01/2024
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