Provider Demographics
NPI:1538991971
Name:VELAZQUEZ, GABRIELLA BERENICE (LPC)
Entity type:Individual
Prefix:
First Name:GABRIELLA
Middle Name:BERENICE
Last Name:VELAZQUEZ
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9440 VISCOUNT BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7054
Mailing Address - Country:US
Mailing Address - Phone:915-730-0610
Mailing Address - Fax:
Practice Address - Street 1:9440 VISCOUNT BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7049
Practice Address - Country:US
Practice Address - Phone:915-799-0747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-15
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92971101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health