Provider Demographics
NPI:1295514438
Name:FABLING, BRAD WILLIAM (LPC)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:WILLIAM
Last Name:FABLING
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1426 KNOTTY PINE WAY
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80108-8012
Mailing Address - Country:US
Mailing Address - Phone:303-790-1404
Mailing Address - Fax:
Practice Address - Street 1:1426 KNOTTY PINE WAY
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80108-8012
Practice Address - Country:US
Practice Address - Phone:303-790-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health