Provider Demographics
NPI:1578282679
Name:GEBEL, GABRIELLE C (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:GABRIELLE
Middle Name:C
Last Name:GEBEL
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2045 W GRAND AVE STE B
Mailing Address - Street 2:PMB 815600
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-1577
Mailing Address - Country:US
Mailing Address - Phone:312-788-7014
Mailing Address - Fax:
Practice Address - Street 1:2045 W GRAND AVE STE B
Practice Address - Street 2:PMB 815600
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-1577
Practice Address - Country:US
Practice Address - Phone:312-788-7014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-23
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.001611103TF0000X
NY002002103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily