Provider Demographics
NPI:1801878871
Name:GIBSON, LINDSAY C (PSY D)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:C
Last Name:GIBSON
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 COLUMBUS CTR
Mailing Address - Street 2:STE 615
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6722
Mailing Address - Country:US
Mailing Address - Phone:757-490-7811
Mailing Address - Fax:757-436-6433
Practice Address - Street 1:1 COLUMBUS CTR
Practice Address - Street 2:STE 615
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6722
Practice Address - Country:US
Practice Address - Phone:757-490-7811
Practice Address - Fax:757-436-6433
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-16
Last Update Date:2009-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001252103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical