Provider Demographics
NPI:1679641088
Name:GIBBS, DIANNA J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANNA
Middle Name:J
Last Name:GIBBS
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Gender:F
Credentials:LCSW
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Mailing Address - Street 1:2101 EAST JEFFERSON STREET
Mailing Address - Street 2:PPQA MEDICARE COMPLIANCE UNIT 6 WEST
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4908
Mailing Address - Country:US
Mailing Address - Phone:301-816-6660
Mailing Address - Fax:301-816-6308
Practice Address - Street 1:8550 LEE HIGHWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4512
Practice Address - Country:US
Practice Address - Phone:703-207-2864
Practice Address - Fax:703-207-2838
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
VA0904003278103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist