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NPI Code Detail

MEDICARE: AMY LYNN GABRIELSKI CADC

MEDICARE:   AMY LYNN GABRIELSKI  CADC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker32019MN
21041C0700XClinical Social WorkerLCSW21914AZ
3101YA0400XAddiction (Substance Use Disorder) CounselorCAC4265ME

General Provider Information

NPI Number : 1285965921
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LYNN GABRIELSKI CADC
Provider Business Mailing Address
First Line : 1205 N F AVE
Second Line :
City : DOUGLAS
State : AZ
Zip : 85607-1920
Country : US
Telephone Number : 520-364-1429
Fax Number : 520-515-8690
Provider Business Practice Location Address
First Line : 4 PARK ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7172
Country : US
Telephone Number : 207-784-0922
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2010
Last Update Date : 01/22/2026

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