Provider Demographics
NPI:1790518157
Name:GAMBRELL, ANN-ELISE GOSS
Entity type:Individual
Prefix:
First Name:ANN-ELISE
Middle Name:GOSS
Last Name:GAMBRELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 HAYFIELD LN
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:SC
Mailing Address - Zip Code:29657-2806
Mailing Address - Country:US
Mailing Address - Phone:864-884-7334
Mailing Address - Fax:
Practice Address - Street 1:309 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2319
Practice Address - Country:US
Practice Address - Phone:864-898-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health