Healthcare Provider Details

I. General information

NPI: 1003743659
Provider Name (Legal Business Name): ANGELA GIBSON, LCSW COUNSELING AND PSYCHOTHERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13658 PLEASANT DR
LARGO FL
33774-4126
US

IV. Provider business mailing address

1901 ULMERTON RD. SUITE 625 #3016
CLEARWATER FL
33762
US

V. Phone/Fax

Practice location:
  • Phone: 727-628-7449
  • Fax: 727-628-7450
Mailing address:
  • Phone: 727-628-7449
  • Fax: 727-628-7450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. ANGELA J GIBSON
Title or Position: OWNER
Credential: LCSW
Phone: 727-628-7449