Provider Demographics
NPI:1821891672
Name:EVERSGERD, GABRIELLE ANN (MHCC-LP, BCN-T)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:ANN
Last Name:EVERSGERD
Suffix:
Gender:
Credentials:MHCC-LP, BCN-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5224
Mailing Address - Country:US
Mailing Address - Phone:516-509-3557
Mailing Address - Fax:
Practice Address - Street 1:727 N BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2348
Practice Address - Country:US
Practice Address - Phone:800-871-5491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No2472E0500XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherEEG