Provider Demographics
NPI:1497575500
Name:FABRIS, NORA (LADC I)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:FABRIS
Suffix:
Gender:F
Credentials:LADC I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 LOCKE ST UNIT 627
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-5504
Mailing Address - Country:US
Mailing Address - Phone:978-857-9233
Mailing Address - Fax:
Practice Address - Street 1:61 BROWN ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6750
Practice Address - Country:US
Practice Address - Phone:978-308-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA23912101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)