Provider Demographics
NPI:1669078218
Name:FARIA, FABIA (LICSW)
Entity type:Individual
Prefix:
First Name:FABIA
Middle Name:
Last Name:FARIA
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-6081
Mailing Address - Country:US
Mailing Address - Phone:978-335-8912
Mailing Address - Fax:
Practice Address - Street 1:44 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-6081
Practice Address - Country:US
Practice Address - Phone:978-335-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222531104100000X
MALICSW1272631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker