Provider Demographics
NPI:1396497780
Name:GIBB, CAITLIN (LCSW, LMFT)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:
Last Name:GIBB
Suffix:
Gender:F
Credentials:LCSW, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 NE 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1934
Mailing Address - Country:US
Mailing Address - Phone:805-602-0276
Mailing Address - Fax:
Practice Address - Street 1:1235 SE DIVISION STREST
Practice Address - Street 2:SUITE 203B
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1087
Practice Address - Country:US
Practice Address - Phone:805-602-0276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTI1411106H00000X
ORL300251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist