Provider Demographics
NPI:1053511477
Name:CLAYTON, GABRIELLE NORA (MA,, LMHC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:NORA
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:MA,, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 4TH AVE E
Mailing Address - Street 2:PMB 232
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4632
Mailing Address - Country:US
Mailing Address - Phone:360-888-5291
Mailing Address - Fax:
Practice Address - Street 1:1327 25TH CT NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-3302
Practice Address - Country:US
Practice Address - Phone:360-888-5291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA#LH000050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health