Healthcare Provider Details

I. General information

NPI: 1952289886
Provider Name (Legal Business Name): MAXINE FABRIZIO MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 BIDEN ST STE 502
SCRANTON PA
18503-1445
US

IV. Provider business mailing address

321 BIDEN ST STE 502
SCRANTON PA
18503-1445
US

V. Phone/Fax

Practice location:
  • Phone: 570-209-8946
  • Fax: 570-209-8946
Mailing address:
  • Phone: 570-209-8946
  • Fax: 570-209-8946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: