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NPI Code Detail

MEDICARE: MS. DIANE GIBBS LPC

MEDICARE: MS. DIANE GIBBS LPC
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 Counselor0701002588VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1087990OTHERVASENTARA
2282728OTHERVAANTHEM

General Provider Information

NPI Number : 1750309712
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANE GIBBS LPC
Provider Business Mailing Address
First Line : 85 SANGERS LN
Second Line :
City : STAUNTON
State : VA
Zip : 24401-6712
Country : US
Telephone Number : 540-887-3200
Fax Number :
Provider Business Practice Location Address
First Line : 85 SANGERS LN
Second Line :
City : STAUNTON
State : VA
Zip : 24401-6712
Country : US
Telephone Number : 540-887-3200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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