Provider Demographics
NPI:1861152001
Name:FABEL, ADAM (LSW, LCSW)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:FABEL
Suffix:
Gender:M
Credentials:LSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1159 KAMAKANA ST APT 108
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2023
Mailing Address - Country:US
Mailing Address - Phone:412-779-0369
Mailing Address - Fax:
Practice Address - Street 1:91-1159 KAMAKANA ST APT 108
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2023
Practice Address - Country:US
Practice Address - Phone:412-779-0369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI46871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty