Provider Demographics
NPI:1710110572
Name:GIBSON, ARTHUR LOUIS JR (CASACT)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:LOUIS
Last Name:GIBSON
Suffix:JR
Gender:M
Credentials:CASACT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FLATBUSH AVE # 206
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2177
Mailing Address - Country:US
Mailing Address - Phone:718-398-0800
Mailing Address - Fax:
Practice Address - Street 1:202 FLATBUSH AVE # 206
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-2177
Practice Address - Country:US
Practice Address - Phone:718-398-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)