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NPI Code Detail

MEDICARE: MRS. NICOLE ALYSSA GIBSON M.S.ED., LPC, NCC

MEDICARE:  MRS. NICOLE ALYSSA GIBSON  M.S.ED., LPC, NCC
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
1101YP2500XProfessional CounselorPC008313PA

General Provider Information

NPI Number : 1649641218
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NICOLE ALYSSA GIBSON M.S.ED., LPC, NCC
Provider Business Mailing Address
First Line : 125 EMERYVILLE DR STE 230
Second Line :
City : CRANBERRY TOWNSHIP
State : PA
Zip : 16066-5020
Country : US
Telephone Number : 724-609-5002
Fax Number : 724-299-8964
Provider Business Practice Location Address
First Line : 125 EMERYVILLE DR STE 230
Second Line :
City : CRANBERRY TOWNSHIP
State : PA
Zip : 16066-5020
Country : US
Telephone Number : 724-609-5002
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2015
Last Update Date : 09/05/2025

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Directions to “ MRS. NICOLE ALYSSA GIBSON M.S.ED., LPC, NCC” Practice Location

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