Provider Demographics
NPI:1366023400
Name:SMITH GIBBS, DAWN (LMSW)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SMITH GIBBS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N VALLEYWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-2448
Mailing Address - Country:US
Mailing Address - Phone:423-314-7768
Mailing Address - Fax:
Practice Address - Street 1:809 N VALLEYWOOD CIR
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-2448
Practice Address - Country:US
Practice Address - Phone:423-314-7768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11251104100000X
TN77921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker