Provider Demographics
NPI:1609898923
Name:FABRIKANT, CRAIG STEVEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:STEVEN
Last Name:FABRIKANT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 N UNIVERSITY DR
Mailing Address - Street 2:STE 500
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33065-1410
Mailing Address - Country:US
Mailing Address - Phone:954-340-7717
Mailing Address - Fax:954-340-7718
Practice Address - Street 1:2855 N UNIVERSITY DR
Practice Address - Street 2:STE 500
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-1410
Practice Address - Country:US
Practice Address - Phone:954-340-7717
Practice Address - Fax:954-340-7718
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8073103T00000X
NJ1965103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical