Provider Demographics
NPI:1497524565
Name:TASSIELLI, GABRIELLE LAUREN (LMHC, NCC, CASAC-T)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:LAUREN
Last Name:TASSIELLI
Suffix:
Gender:F
Credentials:LMHC, NCC, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ANNA ST
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6902
Mailing Address - Country:US
Mailing Address - Phone:631-327-2388
Mailing Address - Fax:
Practice Address - Street 1:16 ANNA ST
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6902
Practice Address - Country:US
Practice Address - Phone:631-327-2388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013265101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)