Provider Demographics
NPI:1447871173
Name:WILLIAMS-HARKEY, GABRIELL CHARLOTTE (CSAC 25183)
Entity type:Individual
Prefix:
First Name:GABRIELL
Middle Name:CHARLOTTE
Last Name:WILLIAMS-HARKEY
Suffix:
Gender:F
Credentials:CSAC 25183
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 PETE MAUNEY RD
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:NC
Mailing Address - Zip Code:28090-9394
Mailing Address - Country:US
Mailing Address - Phone:704-745-8123
Mailing Address - Fax:
Practice Address - Street 1:1895 E DIXON BLVD
Practice Address - Street 2:
Practice Address - City:SHELBY
Practice Address - State:NC
Practice Address - Zip Code:28152-6901
Practice Address - Country:US
Practice Address - Phone:704-466-3970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25183101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)