Provider Demographics
NPI:1629514740
Name:PATTON, GABRIELLE (LCPC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:PATTON
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 1:5301 76TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784
Mailing Address - Country:US
Mailing Address - Phone:301-459-2121
Mailing Address - Fax:
Practice Address - Street 1:5301 76TH AVE
Practice Address - Street 2:
Practice Address - City:LANDOVER HILLS
Practice Address - State:MD
Practice Address - Zip Code:20784-1703
Practice Address - Country:US
Practice Address - Phone:301-459-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-12
Last Update Date:2017-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health