Provider Demographics
NPI:1235651464
Name:ABOGADO, GABRIELLE THIBODEAUX (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:GABRIELLE
Middle Name:THIBODEAUX
Last Name:ABOGADO
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1967 LANCASTER CT APT 1
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2057
Mailing Address - Country:US
Mailing Address - Phone:773-354-6244
Mailing Address - Fax:
Practice Address - Street 1:1967 LANCASTER CT APT 1
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60565-2057
Practice Address - Country:US
Practice Address - Phone:773-354-6244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.011030101Y00000X, 101YP2500X, 101YM0800X
IL1899529101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool