Provider Demographics
NPI:1750831285
Name:JANINE J FABRIZIO LCSW LCADC
Entity Type:Organization
Organization Name:JANINE J FABRIZIO LCSW LCADC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:K
Authorized Official - Last Name:FABRIZIO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LCADC
Authorized Official - Phone:609-805-1200
Mailing Address - Street 1:1067 W SUMMER AVE
Mailing Address - Street 2:
Mailing Address - City:MINOTOLA
Mailing Address - State:NJ
Mailing Address - Zip Code:08341-1032
Mailing Address - Country:US
Mailing Address - Phone:609-805-1200
Mailing Address - Fax:
Practice Address - Street 1:123 EGG HARBOR RD STE 202
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-9406
Practice Address - Country:US
Practice Address - Phone:609-805-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-07
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05679900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty