Provider Demographics
NPI:1841794609
Name:GIBSON COUNSELING CENTER
Entity Type:Organization
Organization Name:GIBSON COUNSELING CENTER
Other - Org Name:THE GIBSON COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:GIBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-487-9996
Mailing Address - Street 1:PO BOX 5565
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-5565
Mailing Address - Country:US
Mailing Address - Phone:304-487-9996
Mailing Address - Fax:833-488-1901
Practice Address - Street 1:109 THORN ST STE E
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-3571
Practice Address - Country:US
Practice Address - Phone:304-487-9996
Practice Address - Fax:833-488-1901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-19
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty