Healthcare Provider Details

I. General information

NPI: 1760043475
Provider Name (Legal Business Name): GABRIELLA BRUMAGHIM LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 CORPORATE DR
HALFMOON NY
12065-8612
US

IV. Provider business mailing address

7 CORPORATE DR
HALFMOON NY
12065-8612
US

V. Phone/Fax

Practice location:
  • Phone: 518-400-0227
  • Fax:
Mailing address:
  • Phone: 518-400-0227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number011783
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: