Provider Demographics
NPI:1316505399
Name:ANNETT, GABRIELLE M (LPC, LISAC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:M
Last Name:ANNETT
Suffix:
Gender:F
Credentials:LPC, LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7281 E EARLL DR STE A2
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7213
Mailing Address - Country:US
Mailing Address - Phone:480-508-1144
Mailing Address - Fax:480-659-4529
Practice Address - Street 1:7281 E EARLL DR STE A2
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-7213
Practice Address - Country:US
Practice Address - Phone:480-508-1144
Practice Address - Fax:480-659-4529
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-15126101YA0400X
AZLPC-17892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)