Provider Demographics
NPI:1649471277
Name:FABRIZIO, KATHERINE KILBURN (MA, LPC, LPA)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:KILBURN
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:MA, LPC, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 OBERLIN RD
Mailing Address - Street 2:629 OBERLIN ROAD
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1126
Mailing Address - Country:US
Mailing Address - Phone:919-280-3995
Mailing Address - Fax:
Practice Address - Street 1:629 OBERLIN RD
Practice Address - Street 2:629 OBERLIN ROAD
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1126
Practice Address - Country:US
Practice Address - Phone:919-280-3995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2793101Y00000X
NC1263103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2793OtherLICENSED PROFESSIONAL COU
NC2793OtherLICENSED PROFESSIONAL COU