Active NPI
Stephen Dillon Fabick, ED.D.
- Clinical Psychologist
- Birmingham, MI
National Provider Identifier
1366431587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301002475
- Practice address
- 640 N Old Woodward Ave
Suite 201
Birmingham, MI 48009-3881 - Phone
- (248) 258-9288
- Fax
- (248) 258-5187
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301002475 | MI | Primary |
Addresses
Primary practice location
640 N Old Woodward Ave
Suite 201
Birmingham, MI 48009-3881
Mailing address
640 N Old Woodward Ave
Suite 201
Birmingham, MI 48009-3881
Phone (248) 258-9288
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 99127 | Other | MI | MANAGED HEALTH NETWORK |
| 0 F3 4657 | Other | MI | BCBS OF MICHIGAN |
| 0001011251 | Other | MI | MHN (VENDOR #) |
| 56941 | Other | MI | CIGNA BEHAVIORAL HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110616000536 | MI | Practitioner - Clinical Psychologist | 5698953891 | Practice locations: Cedar, MI |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1366431587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 N OLD WOODWARD AVE",
"address_2": "SUITE 201",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480093881",
"telephone_number": "248-258-9288",
"fax_number": "248-258-5187"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 N OLD WOODWARD AVE",
"address_2": "SUITE 201",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480093881",
"telephone_number": "248-258-9288",
"fax_number": "248-258-5187"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABICK",
"first_name": "STEPHEN",
"middle_name": "DILLON",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301002475",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "99127",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF MICHIGAN",
"identifier": "0 F3 4657",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHN (VENDOR #)",
"identifier": "0001011251",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "56941",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.