Provider Demographics
NPI:1730984451
Name:MCCABE, GILLIAN ALEXA (PHD)
Entity type:Individual
Prefix:
First Name:GILLIAN
Middle Name:ALEXA
Last Name:MCCABE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12004 ZIA RD NE APT E8
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1348
Mailing Address - Country:US
Mailing Address - Phone:312-576-8546
Mailing Address - Fax:
Practice Address - Street 1:1 SAN RAFAEL AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-1116
Practice Address - Country:US
Practice Address - Phone:505-823-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPSY-2025-0004103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical