MEDICARE: GIBBONS AKENJI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164353439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIBBONS AKENJI

Provider Business Mailing Address
First Line	:	1114 BROOKVIEW DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-7503
Country	:	US
Telephone Number	:	945-267-0835
Fax Number	:	945-267-0835

Provider Business Practice Location Address
First Line	:	1114 BROOKVIEW DR
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43615-7503
Country	:	US
Telephone Number	:	945-267-0835
Fax Number	:	945-267-0835

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ GIBBONS AKENJI ” Practice Location

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