Provider Demographics
NPI:1386243723
Name:GIMPEL, GRACIELA YUE YANG
Entity type:Individual
Prefix:
First Name:GRACIELA
Middle Name:YUE YANG
Last Name:GIMPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 WASHINGTON RD STE 206
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-2816
Mailing Address - Country:US
Mailing Address - Phone:720-647-6700
Mailing Address - Fax:720-647-6777
Practice Address - Street 1:520 WASHINGTON RD STE 206
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-2816
Practice Address - Country:US
Practice Address - Phone:720-647-6700
Practice Address - Fax:720-647-6777
Is Sole Proprietor?:No
Enumeration Date:2020-10-17
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC000444101YM0800X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician