Provider Demographics
NPI:1255106688
Name:TRIPP, GABRELLE (LMSW, LCSW)
Entity type:Individual
Prefix:
First Name:GABRELLE
Middle Name:
Last Name:TRIPP
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 TOWNES PL
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22405-2093
Mailing Address - Country:US
Mailing Address - Phone:601-620-3519
Mailing Address - Fax:
Practice Address - Street 1:71 TOWNES PL
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22405-2093
Practice Address - Country:US
Practice Address - Phone:601-620-3519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040160681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical