Provider Demographics
NPI:1336929363
Name:ACOSTA, GABRIELA IVETTE (LPC A)
Entity Type:Individual
Prefix:
First Name:GABRIELA
Middle Name:IVETTE
Last Name:ACOSTA
Suffix:
Gender:F
Credentials:LPC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10737 GATEWAY BLVD W
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4920
Mailing Address - Country:US
Mailing Address - Phone:915-820-6272
Mailing Address - Fax:
Practice Address - Street 1:10737 GATEWAY BLVD W
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4920
Practice Address - Country:US
Practice Address - Phone:915-820-6272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-05
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health