Provider Demographics
NPI:1134998693
Name:DEVILBISS, GRACIELA VANESSA (LGPC)
Entity type:Individual
Prefix:
First Name:GRACIELA
Middle Name:VANESSA
Last Name:DEVILBISS
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1312 IRVING ST NW LOWR UNIT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2314
Mailing Address - Country:US
Mailing Address - Phone:312-539-9063
Mailing Address - Fax:
Practice Address - Street 1:1525 7TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3201
Practice Address - Country:US
Practice Address - Phone:202-951-1481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLGPC200001652101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health