Provider Demographics
NPI:1275728941
Name:GIBSON, RACHEL M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:M
Last Name:GIBSON
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 1:445 E FM 1382 STE 3-184
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-6047
Mailing Address - Country:US
Mailing Address - Phone:972-998-1643
Mailing Address - Fax:972-274-2526
Practice Address - Street 1:1107 NOBLEWOOD DR
Practice Address - Street 2:
Practice Address - City:GLENN HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:75154-8769
Practice Address - Country:US
Practice Address - Phone:972-998-1643
Practice Address - Fax:972-274-2526
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61947101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional