Provider Demographics
NPI:1235204926
Name:GABRIEL, KAREN MICHEEL (MED, LMHC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MICHEEL
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:MED, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 MARSH LANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-1416
Mailing Address - Country:US
Mailing Address - Phone:904-280-0471
Mailing Address - Fax:904-273-1400
Practice Address - Street 1:4300 MARSH LANDING BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-1416
Practice Address - Country:US
Practice Address - Phone:904-280-0471
Practice Address - Fax:904-273-1400
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH6579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ040COtherBLUE CROSS & BLUE SHIELD