Provider Demographics
NPI:1295497030
Name:GILBERT, ELAINE THERESE (LPC, LCDC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:THERESE
Last Name:GILBERT
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1134
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-1134
Mailing Address - Country:US
Mailing Address - Phone:214-207-4197
Mailing Address - Fax:
Practice Address - Street 1:2101 GLENCOE DR
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2403
Practice Address - Country:US
Practice Address - Phone:214-207-4197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83444101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health