MEDICARE: LUKE FABISIAK MS, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC019634	PA

General Provider Information

NPI Number	:	1568399376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE FABISIAK MS, LPC

Provider Business Mailing Address
First Line	:	215 EXECUTIVE DR STE 102
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-6408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	215 EXECUTIVE DR STE 102
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-6408
Country	:	US
Telephone Number	:	724-776-5690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/06/2026

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