Provider Demographics
NPI:1992156038
Name:GREENWALD, GAVRIELE SHOSHANNA (LMHC)
Entity type:Individual
Prefix:MISS
First Name:GAVRIELE
Middle Name:SHOSHANNA
Last Name:GREENWALD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1440 10TH ST STE 101B
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7043
Mailing Address - Country:US
Mailing Address - Phone:360-328-7040
Mailing Address - Fax:
Practice Address - Street 1:2 MARIGOLD DR UNIT 41
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98229-2798
Practice Address - Country:US
Practice Address - Phone:360-328-7040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-30
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor