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General NPI Number Information
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NPI Number | 1235651464
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Entity Type | Individual
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Provider Name | GABRIELLE THIBODEAUX ABOGADO LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1967 LANCASTER CT APT 1
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City | NAPERVILLE
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State | IL
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Zip | 60565-2057
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Country | US
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Telephone | 773-354-6244
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Fax |
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Provider Business Mailing Address
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Address Line | 1967 LANCASTER CT APT 1
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City | NAPERVILLE
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State | IL
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Zip | 60565-2057
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Country | US
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Telephone | 773-354-6244
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 180.011030
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.011030
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 1899529
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 180.011030
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License Number State | IL
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