Provider Demographics
NPI:1164675435
Name:KIBBY, GALE OLIVER (LPC)
Entity Type:Individual
Prefix:MS
First Name:GALE
Middle Name:OLIVER
Last Name:KIBBY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3870 ROSIN CT
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1620
Mailing Address - Country:US
Mailing Address - Phone:916-363-1553
Mailing Address - Fax:
Practice Address - Street 1:3870 ROSIN CT
Practice Address - Street 2:SUITE 130
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1620
Practice Address - Country:US
Practice Address - Phone:916-363-1553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-30
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005038671101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health