Provider Demographics
NPI:1275190712
Name:MOSS, GABRIELLE ASHLEY (LPC, ADC)
Entity Type:Individual
Prefix:MISS
First Name:GABRIELLE
Middle Name:ASHLEY
Last Name:MOSS
Suffix:
Gender:F
Credentials:LPC, ADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CLEVELAND ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-2410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:864-467-2011
Practice Address - Street 1:1400 CLEVELAND ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-2410
Practice Address - Country:US
Practice Address - Phone:864-467-3776
Practice Address - Fax:864-467-2011
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)