Provider Demographics
NPI:1215825153
Name:LAVERGNE, GABRIELLE
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:LAVERGNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FINN
Other - Middle Name:
Other - Last Name:LAVERGNE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2425 ETTERS LN
Mailing Address - Street 2:
Mailing Address - City:CASSATT
Mailing Address - State:SC
Mailing Address - Zip Code:29032-8903
Mailing Address - Country:US
Mailing Address - Phone:803-606-3363
Mailing Address - Fax:
Practice Address - Street 1:738 W LIBERTY ST
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4745
Practice Address - Country:US
Practice Address - Phone:803-757-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst