Healthcare Provider Details

I. General information

NPI: 1366804981
Provider Name (Legal Business Name): KAITLIN MARIE GIBSON MA, ATR-BC, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1844 BABCOCK BLVD
PITTSBURGH PA
15209-1302
US

IV. Provider business mailing address

3090 HENRICH FARM LN
ALLISON PARK PA
15101-1519
US

V. Phone/Fax

Practice location:
  • Phone: 585-281-9942
  • Fax:
Mailing address:
  • Phone: 585-281-9942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC008785
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: