Provider Demographics
NPI:1689620924
Name:SHIBEL, GINA CAMILLE (LPC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:CAMILLE
Last Name:SHIBEL
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 1:2 E 59TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64113-2116
Mailing Address - Country:US
Mailing Address - Phone:816-363-1898
Mailing Address - Fax:816-822-7711
Practice Address - Street 1:2 E 59TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64113-2116
Practice Address - Country:US
Practice Address - Phone:816-363-1898
Practice Address - Fax:816-822-7711
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002018280101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO31600018OtherBCBSKC