Provider Demographics
NPI:1033839485
Name:GENOVA, GABRIELLA (MA, LPCC)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:
Last Name:GENOVA
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3460 S FEDERAL BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:CO
Mailing Address - Zip Code:80110-1967
Mailing Address - Country:US
Mailing Address - Phone:303-761-0200
Mailing Address - Fax:
Practice Address - Street 1:3460 S FEDERAL BLVD
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:CO
Practice Address - Zip Code:80110-1967
Practice Address - Country:US
Practice Address - Phone:303-761-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-29
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0022494101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional