Individual
GABRIELLE H EDIDIN
Active
Individual
GABRIELLE H EDIDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SW-2026-0324
NM
1041C0700X
Clinical Social Worker
Primary
X-12306
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15492053
CAQH
NM
Enumeration date
01/25/2022
Last updated
04/03/2026
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