Healthcare Provider Details

I. General information

NPI: 1609752781
Provider Name (Legal Business Name): LAURA ANASTASIA GABELLA CDCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23611 CHAGRIN BLVD STE 103
BEACHWOOD OH
44122-5540
US

IV. Provider business mailing address

23611 CHAGRIN BLVD STE 103
BEACHWOOD OH
44122-5540
US

V. Phone/Fax

Practice location:
  • Phone: 216-373-3134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCDCA.197119
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberQMHSIII
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: