Provider Demographics
NPI:1093374142
Name:GABEL, LAUREN (BCBA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:GABEL
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SLONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCBA
Mailing Address - Street 1:3000 W GEORGE ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-7609
Mailing Address - Country:US
Mailing Address - Phone:574-238-6357
Mailing Address - Fax:
Practice Address - Street 1:3000 W GEORGE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-7609
Practice Address - Country:US
Practice Address - Phone:574-238-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-19-40439103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-19-40439OtherBACB