Provider Demographics
NPI:1225851520
Name:HROBUCHAK, GAIL GOODLING (LCMHC)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:GOODLING
Last Name:HROBUCHAK
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:GAIL
Other - Middle Name:ANNE
Other - Last Name:GOODLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2220 BANYON GROVE LOOP
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-3938
Mailing Address - Country:US
Mailing Address - Phone:717-982-1217
Mailing Address - Fax:
Practice Address - Street 1:2220 BANYON GROVE LOOP
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-3938
Practice Address - Country:US
Practice Address - Phone:717-982-1217
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-05
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20742101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health