Provider Demographics
NPI:1124331384
Name:SARFATY, GABRIELLE FELLIG (LPCC)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:FELLIG
Last Name:SARFATY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13208 DELLA LONGA LN NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-2936
Mailing Address - Country:US
Mailing Address - Phone:505-845-9704
Mailing Address - Fax:505-844-4091
Practice Address - Street 1:1515 EUBANK SE,
Practice Address - Street 2:MS1032
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87185-1032
Practice Address - Country:US
Practice Address - Phone:505-845-9704
Practice Address - Fax:505-844-4091
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0132851101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health