Provider Demographics
NPI:1407244205
Name:LOCKE, GABRIELLA EMMARI (PHD, LPC, CSAT, CATP)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:EMMARI
Last Name:LOCKE
Suffix:
Gender:F
Credentials:PHD, LPC, CSAT, CATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 BROWNSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9234
Mailing Address - Country:US
Mailing Address - Phone:724-970-3713
Mailing Address - Fax:
Practice Address - Street 1:2401 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:SOUTH PARK
Practice Address - State:PA
Practice Address - Zip Code:15129-9234
Practice Address - Country:US
Practice Address - Phone:724-970-3713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-31
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC007892101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor