Provider Demographics
NPI:1205063617
Name:GABRIEL, MELISSA S (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:S
Last Name:GABRIEL
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 1:114 E CUTHBERT BLVD
Mailing Address - Street 2:APT. J-4
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-1848
Mailing Address - Country:US
Mailing Address - Phone:856-868-1838
Mailing Address - Fax:
Practice Address - Street 1:300 HARPER DRIVE
Practice Address - Street 2:THE COMMUNITY CENTER OF MOORESTOWN VNA
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057
Practice Address - Country:US
Practice Address - Phone:856-380-1070
Practice Address - Fax:856-552-1315
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005244001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical