Provider Demographics
NPI:1912250945
Name:GIBSON, JULIE CHRISTINE (LPC)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:CHRISTINE
Last Name:GIBSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 SHADWELL WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:FRIENDSWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77546-5735
Mailing Address - Country:US
Mailing Address - Phone:713-857-9875
Mailing Address - Fax:281-310-6334
Practice Address - Street 1:107 SHADWELL WAY STE 105
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5735
Practice Address - Country:US
Practice Address - Phone:713-857-9875
Practice Address - Fax:281-310-6334
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67471101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional