Healthcare Provider Details

I. General information

NPI: 1992654784
Provider Name (Legal Business Name): GABRIELLA FRANCESCA MICELI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 01/24/2026
Certification Date: 01/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 E IDAHO AVE STE 14
LAS CRUCES NM
88005-3241
US

IV. Provider business mailing address

5512 KALAHARI LN
LAS CRUCES NM
88011-7252
US

V. Phone/Fax

Practice location:
  • Phone: 575-209-4269
  • Fax:
Mailing address:
  • Phone: 575-952-0652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCTB-2023-0670
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: