Healthcare Provider Details

I. General information

NPI: 1326902479
Provider Name (Legal Business Name): GABRIELLE RAYNE BELENCHIA LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 N MAIN ST STE 2A
SOUTHINGTON CT
06489-2572
US

IV. Provider business mailing address

122 N PROSPECT STREET EXT
ANSONIA CT
06401-3025
US

V. Phone/Fax

Practice location:
  • Phone: 203-568-5923
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9216
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: