Individual provider · Type 1 NPI

Gabriella T. Jack, NCC, LPC

Mental Health Counselor · Fairfax, VA

NPI number 1174116248 Active

Practice location

9301 Santayana Dr
Fairfax, VA 22031-3069

Call (571) 502-8362 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X0701010212 (VA)

Mental Health Counselor: Definition to come...

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About NPI 1174116248

Gabriella T. Jack, NCC, LPC's National Provider Identifier is 1174116248, issued on Feb 18, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Fairfax, VA. The record was last updated on Feb 18, 2021.