Provider Demographics
NPI:1114681244
Name:GIBBONS, LAURA ANN (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 N DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-4331
Mailing Address - Country:US
Mailing Address - Phone:317-417-7676
Mailing Address - Fax:
Practice Address - Street 1:23 S 8TH ST STE 600
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-2641
Practice Address - Country:US
Practice Address - Phone:800-766-0068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist