Provider Demographics
NPI:1053844100
Name:GIBBS, ANEYA (MSW,LCSWS)
Entity Type:Individual
Prefix:
First Name:ANEYA
Middle Name:
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MSW,LCSWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 ACORN FALLS CT
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-5906
Mailing Address - Country:US
Mailing Address - Phone:919-480-7109
Mailing Address - Fax:919-954-7363
Practice Address - Street 1:212 ACORN FALLS CT
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-5906
Practice Address - Country:US
Practice Address - Phone:919-480-7109
Practice Address - Fax:919-954-7363
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80513171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical