Provider Demographics
NPI:1720473218
Name:GIBSON, CECILY (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CECILY
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:CECILY
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:4630 50TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-3521
Mailing Address - Country:US
Mailing Address - Phone:575-652-7688
Mailing Address - Fax:
Practice Address - Street 1:4630 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-3521
Practice Address - Country:US
Practice Address - Phone:575-652-7688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-01
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX202205106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist