Provider Demographics
NPI:1659755213
Name:MARY LOUISE GABRIEL, LMHC
Entity Type:Organization
Organization Name:MARY LOUISE GABRIEL, LMHC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMHC
Authorized Official - Prefix:
Authorized Official - First Name:MARY LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:917-604-5592
Mailing Address - Street 1:6350 PLEASANTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-1844
Mailing Address - Country:US
Mailing Address - Phone:917-604-5592
Mailing Address - Fax:718-894-0285
Practice Address - Street 1:6350 PLEASANTVIEW ST
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-1844
Practice Address - Country:US
Practice Address - Phone:917-604-5592
Practice Address - Fax:718-894-0285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000482-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty