Provider Demographics
NPI:1891990800
Name:GIBBS, SONITA CHEVETTE (LPC)
Entity Type:Individual
Prefix:
First Name:SONITA
Middle Name:CHEVETTE
Last Name:GIBBS
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:PO BOX 1735
Mailing Address - Street 2:83 BLUE RIDGE DEVELOPMENT ROAD
Mailing Address - City:FAIRVIEW
Mailing Address - State:NC
Mailing Address - Zip Code:28730-1735
Mailing Address - Country:US
Mailing Address - Phone:828-628-0105
Mailing Address - Fax:
Practice Address - Street 1:83 BLUE RIDGE DEVELOPMENT ROAD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:NC
Practice Address - Zip Code:28730-1735
Practice Address - Country:US
Practice Address - Phone:828-628-0105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC45443101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional