Provider Demographics
NPI:1932657566
Name:KING, GABRIELLA JANET F G (MS, LGPC)
Entity Type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:JANET F G
Last Name:KING
Suffix:
Gender:F
Credentials:MS, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4201
Mailing Address - Country:US
Mailing Address - Phone:301-498-4316
Mailing Address - Fax:301-498-4316
Practice Address - Street 1:1400 SPRING ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2735
Practice Address - Country:US
Practice Address - Phone:301-589-2303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-12
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7109101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor