Provider Demographics
NPI:1366719270
Name:GELINAS, GABRIELLE L (LPC)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:L
Last Name:GELINAS
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:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-0042
Mailing Address - Country:US
Mailing Address - Phone:860-833-7487
Mailing Address - Fax:
Practice Address - Street 1:80 SHUNPIKE RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-4401
Practice Address - Country:US
Practice Address - Phone:860-833-7487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-20
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001975101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health