Healthcare Provider Details

I. General information

NPI: 1578287736
Provider Name (Legal Business Name): GABRIELLE WRIGHT LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2022
Last Update Date: 10/03/2022
Certification Date: 09/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 SILVER SPRING AVE
SILVER SPRING MD
20910-5052
US

IV. Provider business mailing address

915 SILVER SPRING AVE APT 406
SILVER SPRING MD
20910-5092
US

V. Phone/Fax

Practice location:
  • Phone: 267-368-8872
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: