Provider Demographics
NPI:1215534748
Name:GIBBONS, LINDSAY
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08327-0411
Mailing Address - Country:US
Mailing Address - Phone:609-774-8431
Mailing Address - Fax:
Practice Address - Street 1:60 W AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360
Practice Address - Country:US
Practice Address - Phone:856-772-5809
Practice Address - Fax:856-772-5852
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical