Provider Demographics
NPI:1942905419
Name:GABRIELLE SAMUELS MARRIAGE & FAMILY THERAPY INC.
Entity type:Organization
Organization Name:GABRIELLE SAMUELS MARRIAGE & FAMILY THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:323-807-2870
Mailing Address - Street 1:5716 SUNNYSLOPE AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY GLEN
Mailing Address - State:CA
Mailing Address - Zip Code:91401-4523
Mailing Address - Country:US
Mailing Address - Phone:323-807-2870
Mailing Address - Fax:
Practice Address - Street 1:5716 SUNNYSLOPE AVE
Practice Address - Street 2:
Practice Address - City:VALLEY GLEN
Practice Address - State:CA
Practice Address - Zip Code:91401-4523
Practice Address - Country:US
Practice Address - Phone:323-807-2870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty