FAIRSKY FOUNDATION – Psychologist, NPI 1033595665

FAIRSKY FOUNDATION is a healthcare provider. based in Detroit, Michigan. specializing in Psychologist. The organization holds a License No. 6301012887 (MI). The NPI Number for FAIRSKY FOUNDATION is 1033595665

Main info

Organization
Name
FAIRSKY FOUNDATION
NPI
1033595665
Phone
(248) 581-8777
Address
1300 Broadway St Ste 400
Authorized Official
DR. DAVID ST. JOHN EXECUTIVE DIRECTOR PHD
Enumeration Date
5 August 2015
Last Update Date
23 August 2022
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for FAIRSKY FOUNDATION

  • 1300 Broadway St Ste 400

    Detroit, MI 482262202

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 230 Collingwood St Ste 250

    Ann Arbor, MI 481033845

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 124 Pearl St Ste 303

    Ypsilanti, MI 481972663

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 905 S CENTER ST

    ROYAL OAK, MI 480673230

    Phone:

    Type: Mailing

  • 464 N Main St

    Plymouth, MI 481701347

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 2020 Raybrook St SE Ste 203

    Grand Rapids, MI 495467717

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 1367 Andrews Ave Lowr

    Lakewood, OH 441072405

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Location

  • 23231 WOODWARD AVE

    FERNDALE, MI 482201361

    Phone: (248) 581-8777

    Fax: (888) 975-9374

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-07-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-07-31 (1046 days ago).

Enrollment records

1

Earliest due date

2023-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20160720000492OClinic/Group PracticeMI2023-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48226)

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Reviews

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Frequently asked questions

Does FAIRSKY FOUNDATION have a public NPI I can cite?
Public records show FAIRSKY FOUNDATION under NPI 1033595665.
Does the public listing show FAIRSKY FOUNDATION as active?
FAIRSKY FOUNDATION's NPI record reflects an active status in NPPES.
What services align with FAIRSKY FOUNDATION's listing?
FAIRSKY FOUNDATION's public classification highlights Psychologist. Clinical services aligned with this taxonomy classification.
Can patients visit FAIRSKY FOUNDATION in Detroit, Michigan?
For routing, start with Detroit, Michigan for FAIRSKY FOUNDATION, then verify phone and hours locally.
Who maintains FAIRSKY FOUNDATION's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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