Healthcare Provider Details

I. General information

NPI: 1790671477
Provider Name (Legal Business Name): GIBBENS FAMILY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E 9TH ST
COZAD NE
69130-1737
US

IV. Provider business mailing address

111 E 9TH ST
COZAD NE
69130-1737
US

V. Phone/Fax

Practice location:
  • Phone: 308-746-2230
  • Fax:
Mailing address:
  • Phone: 308-746-2230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. ELIZABETH GIBBENS
Title or Position: OWNER
Credential: LIMHP
Phone: 308-746-2230