Provider Demographics
NPI:1255944344
Name:GEREAU, GABRIELL L (LMHC)
Entity type:Individual
Prefix:
First Name:GABRIELL
Middle Name:L
Last Name:GEREAU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:GABRIELL
Other - Middle Name:L
Other - Last Name:STRUBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HUDSON ST APT 39
Mailing Address - Street 2:
Mailing Address - City:NORTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01532-1666
Mailing Address - Country:US
Mailing Address - Phone:585-331-3256
Mailing Address - Fax:
Practice Address - Street 1:200 HUDSON ST APT 39
Practice Address - Street 2:
Practice Address - City:NORTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01532-1666
Practice Address - Country:US
Practice Address - Phone:585-331-3256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY014242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health