Provider Demographics
NPI:1245562388
Name:GIBSON, KRISTIN (LPC)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:KRISTI
Other - Middle Name:
Other - Last Name:BJORKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3001 QUAIL SPRINGS PKWY FL 5
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-2640
Mailing Address - Country:US
Mailing Address - Phone:405-606-2260
Mailing Address - Fax:405-606-2241
Practice Address - Street 1:117 PARK AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-9030
Practice Address - Country:US
Practice Address - Phone:405-606-2260
Practice Address - Fax:405-606-2241
Is Sole Proprietor?:No
Enumeration Date:2010-01-30
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPC04507101YP2500X
OK4507101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK4507OtherOKLAHOMA STATE LICENSE NUMBER