Provider Demographics
NPI:1245046465
Name:BORBA, GABRIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:
Last Name:BORBA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:GABRIELLE
Other - Middle Name:
Other - Last Name:GERVAIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30 LEE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-4724
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 LEE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-4724
Practice Address - Country:US
Practice Address - Phone:646-770-6859
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0794071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical