Provider Demographics
NPI:1174270714
Name:PADEREWSKI, GABRIELLE ANNA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLE
Middle Name:ANNA
Last Name:PADEREWSKI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 HUNT DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-8956
Mailing Address - Country:US
Mailing Address - Phone:912-667-0100
Mailing Address - Fax:
Practice Address - Street 1:5102 PAULSEN ST BLDG 8
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4624
Practice Address - Country:US
Practice Address - Phone:912-655-8855
Practice Address - Fax:912-335-6571
Is Sole Proprietor?:No
Enumeration Date:2022-03-03
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW0105461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical