Provider Demographics
NPI:1730484825
Name:GIBNEY, KRISTI NICOLE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:NICOLE
Last Name:GIBNEY
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 HERITAGE VILLAGE PLZ
Mailing Address - Street 2:SUITE 125
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3065
Mailing Address - Country:US
Mailing Address - Phone:540-216-1840
Mailing Address - Fax:
Practice Address - Street 1:2006 TOWN PLAZA CT
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-6216
Practice Address - Country:US
Practice Address - Phone:407-432-4452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-20
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701005291101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health