Provider Demographics
NPI:1083108187
Name:GIBSON, ANDREW SCOTT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:SCOTT
Last Name:GIBSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 N IRVINE ST STE 6
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4902
Mailing Address - Country:US
Mailing Address - Phone:864-643-2735
Mailing Address - Fax:864-881-2725
Practice Address - Street 1:11 N IRVINE ST STE 6
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-4902
Practice Address - Country:US
Practice Address - Phone:864-656-5807
Practice Address - Fax:864-881-2725
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-21
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling