Provider Demographics
NPI:1699012773
Name:GIBSON, FAITH (LPC)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:
Last Name:GIBSON
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 1:1510 N HAMPTON RD STE 270
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-8310
Mailing Address - Country:US
Mailing Address - Phone:469-930-6360
Mailing Address - Fax:469-930-6362
Practice Address - Street 1:1510 N HAMPTON RD STE 270
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115-8310
Practice Address - Country:US
Practice Address - Phone:469-930-6360
Practice Address - Fax:469-930-6362
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional