Active NPI
Douglas Blaine Fabian, LICENSED SOCIAL WORK
- Mental Health Counselor
- Buffalo, NY
National Provider Identifier
1982898334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0192041
- Practice address
- 2969 Main St
Suicide Prevention and Crisis Service Inc
Buffalo, NY 14214 - Phone
- (716) 834-2310
- Fax
- (716) 834-9881
- NPI assigned
- Aug 29, 2007
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0192041 | NY | Primary |
Addresses
Primary practice location
2969 Main St
Suicide Prevention and Crisis Service Inc
Buffalo, NY 14214
Mailing address
2969 Main St
Suicide Prevention and Crisis Service Inc
Buffalo, NY 14214
Phone (716) 834-2310
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0192041 | Other | NY STATE LICENSE SOCIAL W |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0192041 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188345600000",
"number": "1982898334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2969 MAIN ST",
"address_2": "SUICIDE PREVENTION AND CRISIS SERVICE INC",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14214",
"telephone_number": "716-834-2310",
"fax_number": "716-834-9881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2969 MAIN ST",
"address_2": "SUICIDE PREVENTION AND CRISIS SERVICE INC",
"city": "BUFFALO",
"state": "NY",
"postal_code": "14214",
"telephone_number": "716-834-2310",
"fax_number": "716-834-9881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FABIAN",
"first_name": "DOUGLAS",
"middle_name": "BLAINE",
"name_prefix": "Mr.",
"credential": "LICENSED SOCIAL WORK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-29",
"last_updated": "2007-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "0192041",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NY STATE LICENSE SOCIAL W",
"identifier": "0192041",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.