Provider Demographics
NPI:1215698147
Name:GAMBLE, RASHELL (LPC)
Entity type:Individual
Prefix:
First Name:RASHELL
Middle Name:
Last Name:GAMBLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3908 CROMWELL LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-2661
Mailing Address - Country:US
Mailing Address - Phone:757-870-7597
Mailing Address - Fax:
Practice Address - Street 1:5360 DISCOVERY PARK BLVD STE 201
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-2860
Practice Address - Country:US
Practice Address - Phone:804-207-6737
Practice Address - Fax:752-952-2654
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701013018101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty