Provider Demographics
NPI:1881063980
Name:MASTRONARDI, GABRIELLA MARIAH (LMHC)
Entity type:Individual
Prefix:MRS
First Name:GABRIELLA
Middle Name:MARIAH
Last Name:MASTRONARDI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14108 JEWEL AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1618
Mailing Address - Country:US
Mailing Address - Phone:347-815-4228
Mailing Address - Fax:
Practice Address - Street 1:10209 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6731
Practice Address - Country:US
Practice Address - Phone:929-260-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009315101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health