Provider Demographics
NPI:1851471551
Name:GIBSON, LINDA LEE (MA LPC NCC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MA LPC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 E COON LAKE RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843
Mailing Address - Country:US
Mailing Address - Phone:810-220-2787
Mailing Address - Fax:810-220-2834
Practice Address - Street 1:2300 GENOA BUSINESS PARK DR STE 180
Practice Address - Street 2:ADVANCED COUNSELING SERVICES
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114
Practice Address - Country:US
Practice Address - Phone:810-220-2787
Practice Address - Fax:810-220-2834
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401007052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health