Provider Demographics
NPI:1245212679
Name:TINDALL-GIBSON, ROSEMARY F (LMFT LPC)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:F
Last Name:TINDALL-GIBSON
Suffix:
Gender:F
Credentials:LMFT LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 RICHARDS ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3836
Mailing Address - Country:US
Mailing Address - Phone:860-283-9887
Mailing Address - Fax:860-283-8488
Practice Address - Street 1:264 RICHARDS ROAD EXT
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3836
Practice Address - Country:US
Practice Address - Phone:860-283-9887
Practice Address - Fax:860-283-8488
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001161101Y00000X
CT000949106H00000X
MA1215106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist