Provider Demographics
NPI:1730831850
Name:GABRIEL, MADISON KIRSTEN (BS)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:KIRSTEN
Last Name:GABRIEL
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE ST APT 334
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37902-1188
Mailing Address - Country:US
Mailing Address - Phone:203-822-2700
Mailing Address - Fax:
Practice Address - Street 1:6926 SHANNON WILLOW RD STE 400
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-1335
Practice Address - Country:US
Practice Address - Phone:704-343-5005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-20
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor