Provider Demographics
NPI:1851960546
Name:BROOKS, GABRIELLE (LMFTA)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8610 NEUSE LANDING LN UNIT 110
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-9038
Mailing Address - Country:US
Mailing Address - Phone:919-397-4252
Mailing Address - Fax:
Practice Address - Street 1:1140 KILDAIRE FARM RD STE 206
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-4597
Practice Address - Country:US
Practice Address - Phone:919-438-0906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12314A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist