Individual
SAMARA FAIRWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADC, LPCC
Contact information
Practice address
11660 ROUND LAKE BLVD NW, COON RAPIDS, MN 55433-2638
(844) 697-8766
Mailing address
1900 SILVER LAKE RD NW, NEW BRIGHTON, MN 55112-1786
(866) 938-4159
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
306766
MN
101YP2500X
Professional Counselor
Primary
5428
MN
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
02/23/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us