Healthcare Provider Details

I. General information

NPI: 1235914516
Provider Name (Legal Business Name): GABRIELLE ENERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST
FREEHOLD NJ
07728-2157
US

IV. Provider business mailing address

74 BRICK BLVD BLDG 4
BRICK NJ
08723-7984
US

V. Phone/Fax

Practice location:
  • Phone: 732-655-6331
  • 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 State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: