Provider Demographics
NPI:1780217364
Name:GABRIELLE CARR LPC
Entity Type:Organization
Organization Name:GABRIELLE CARR LPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:814-746-2691
Mailing Address - Street 1:360 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16441-8312
Mailing Address - Country:US
Mailing Address - Phone:814-746-2691
Mailing Address - Fax:814-240-5843
Practice Address - Street 1:210 S. HIGH ST.
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:PA
Practice Address - Zip Code:16441-8312
Practice Address - Country:US
Practice Address - Phone:814-813-1671
Practice Address - Fax:814-240-1671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-21
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty