Provider Demographics
NPI:1932972189
Name:YOUNG, GABRIELLE DEVON (MSW, LSW, CSAYC)
Entity Type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:DEVON
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MSW, LSW, CSAYC
Other - Prefix:
Other - First Name:GABIE
Other - Middle Name:
Other - Last Name:YOUNG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 532295
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46253-2295
Mailing Address - Country:US
Mailing Address - Phone:317-210-3432
Mailing Address - Fax:
Practice Address - Street 1:6401 GATEWAY DR # 532295
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-2730
Practice Address - Country:US
Practice Address - Phone:317-210-3432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-31
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007581A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical