Provider Demographics
NPI:1336450451
Name:GONYEA, SABLE ELIZABETH (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SABLE
Middle Name:ELIZABETH
Last Name:GONYEA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 N MAIN ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-9213
Mailing Address - Country:US
Mailing Address - Phone:817-886-5777
Mailing Address - Fax:
Practice Address - Street 1:621 N MAIN ST
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-9213
Practice Address - Country:US
Practice Address - Phone:817-886-5777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2016-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490149101041C0700X
TX607281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical