Provider Demographics
NPI:1558164897
Name:CEBALLOS, GABRIELLE LOVE (LCSW)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:LOVE
Last Name:CEBALLOS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 W WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-4619
Mailing Address - Country:US
Mailing Address - Phone:972-786-2822
Mailing Address - Fax:
Practice Address - Street 1:912 W WILLOW ST
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-4619
Practice Address - Country:US
Practice Address - Phone:972-786-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1034571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical