MEDICARE: GABRIELLE LOVE CEBALLOS LCSW

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
1	1041C0700X	Clinical Social Worker	103457	TX

General Provider Information

NPI Number	:	1558164897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GABRIELLE LOVE CEBALLOS LCSW

Provider Business Mailing Address
First Line	:	10685B HAZELHURST DR # 42363
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-3238
Country	:	US
Telephone Number	:	972-786-2822
Fax Number	:

Provider Business Practice Location Address
First Line	:	10685B HAZELHURST DR # 42363
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77043-3238
Country	:	US
Telephone Number	:	972-786-2822
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	01/21/2026

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