Provider Demographics
NPI:1063093235
Name:MOODY, GABRIELLE KRISTINE (MS, LPC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:KRISTINE
Last Name:MOODY
Suffix:
Gender:
Credentials:MS, LPC
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:KRISTINE
Other - Last Name:MOODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GABRIELLE K VARGAS
Mailing Address - Street 1:11427 RAINDROP DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3521
Mailing Address - Country:US
Mailing Address - Phone:713-859-5384
Mailing Address - Fax:
Practice Address - Street 1:11427 RAINDROP DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3521
Practice Address - Country:US
Practice Address - Phone:713-859-5384
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92948101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health