Provider Demographics
NPI:1376219329
Name:FABRIZIO, MARIA ROSEANN (LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ROSEANN
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-3134
Mailing Address - Country:US
Mailing Address - Phone:716-213-3516
Mailing Address - Fax:
Practice Address - Street 1:624 RIVER RD
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6563
Practice Address - Country:US
Practice Address - Phone:716-693-9961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
NY106347104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker