Provider Demographics
NPI:1477708287
Name:GIBBS, ALLISON DENISE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:DENISE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MSW, LCSW
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 254
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19003-0254
Mailing Address - Country:US
Mailing Address - Phone:267-666-8083
Mailing Address - Fax:
Practice Address - Street 1:104 1/2 FORREST AVE STE 28
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2220
Practice Address - Country:US
Practice Address - Phone:267-666-8083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0080771041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical