Provider Demographics
NPI:1821754185
Name:DE LA FLOR, GABRIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:DE LA FLOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7511 DEVRIES DR
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1605
Mailing Address - Country:US
Mailing Address - Phone:757-651-2376
Mailing Address - Fax:
Practice Address - Street 1:9420 FAIRFAX BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031
Practice Address - Country:US
Practice Address - Phone:443-393-3657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-11
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040133481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical