Individual provider · Type 1 NPI
Mari Gwyn Anderson Fairchild, LADC
Mental Health Counselor · Minnetonka, MN
NPI number
1487596409
Active
Practice location
5900 Green Oak Dr # 306
Minnetonka, MN 55343-4708
Fax (612) 484-3752
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | 5770 (MN) |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 307588 (MN) |
Mental Health Counselor: Definition to come...
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About NPI 1487596409
Mari Gwyn Anderson Fairchild, LADC's National Provider Identifier is 1487596409, issued on Apr 8, 2026. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Minnetonka, MN. The record was last updated on Aug 17, 2026.