Provider Demographics
NPI:1174766042
Name:FABIAN, JANET L (LCSW)
Entity type:Individual
Prefix:MS
First Name:JANET
Middle Name:L
Last Name:FABIAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:JANET
Other - Middle Name:L
Other - Last Name:FABIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1019 E WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3332
Mailing Address - Country:US
Mailing Address - Phone:607-733-5696
Mailing Address - Fax:607-737-1379
Practice Address - Street 1:1019 E WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3332
Practice Address - Country:US
Practice Address - Phone:607-733-5696
Practice Address - Fax:607-737-1379
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY 075387-1104100000X
NY0806231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker