Provider Demographics
NPI:1972907384
Name:GIBBS, JAMIE (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GIBBS
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:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:WHEAT RIDGE
Mailing Address - State:CO
Mailing Address - Zip Code:80034-2122
Mailing Address - Country:US
Mailing Address - Phone:720-629-2729
Mailing Address - Fax:
Practice Address - Street 1:14221 E 4TH AVE STE 340
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-8727
Practice Address - Country:US
Practice Address - Phone:720-629-2729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional