Healthcare Provider Details

I. General information

NPI: 1174012694
Provider Name (Legal Business Name): GABRIELLE MARGARET ALBERS LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2018
Last Update Date: 05/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 TECHNOLOGY DR E
MENOMONIE WI
54751-2370
US

IV. Provider business mailing address

PO BOX 309
SIREN WI
54872-0309
US

V. Phone/Fax

Practice location:
  • Phone: 715-235-4245
  • Fax: 888-293-7837
Mailing address:
  • Phone: 715-349-7069
  • Fax: 888-625-8634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6879-125
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: