Provider Demographics
NPI:1336010776
Name:GUADALUPE, GABRIELLE (LMHC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:GUADALUPE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 CORBIN AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-6917
Mailing Address - Country:US
Mailing Address - Phone:201-290-4625
Mailing Address - Fax:
Practice Address - Street 1:352 7TH AVE RM 1201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5815
Practice Address - Country:US
Practice Address - Phone:917-426-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016641101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health