Provider Demographics
NPI:1508983255
Name:GIBSON, CATHERINE WARD (MA LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:WARD
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MA LMHC
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 4728
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32793-4728
Mailing Address - Country:US
Mailing Address - Phone:407-657-5800
Mailing Address - Fax:407-657-4269
Practice Address - Street 1:120 UNIVERSITY PARK DRIVE
Practice Address - Street 2:SUITE 215
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792
Practice Address - Country:US
Practice Address - Phone:407-657-5800
Practice Address - Fax:407-657-4269
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH1561101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health