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NPI Code Detail

MEDICARE: ELLEN FABES LMSW

MEDICARE: ELLEN FABES LMSW
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
11041C0700XClinical Social Worker6801034138MI
2104100000XSocial Worker6801034138MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1750910829OTHERMIBCBSM

General Provider Information

NPI Number : 1972777456
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN FABES LMSW
Provider Business Mailing Address
First Line : 19907 DANUBE CT
Second Line :
City : CHELSEA
State : MI
Zip : 48118-9336
Country : US
Telephone Number : 734-237-9500
Fax Number :
Provider Business Practice Location Address
First Line : 114 N MAIN ST STE 11
Second Line :
City : CHELSEA
State : MI
Zip : 48118-1514
Country : US
Telephone Number : 734-237-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2008
Last Update Date : 05/14/2026

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