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General NPI Number Information
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NPI Number | 1033251145
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Entity Type | Individual
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Provider Name | KAREN ANN GIBSON LPC
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 6555 15 MILE RD
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4511
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Country | US
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Telephone | 586-783-8113
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Fax |
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Provider Business Mailing Address
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Address Line | 19766 KEMP ST
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City | CLINTON TWP
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State | MI
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Zip | 48035-3481
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Country | US
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Telephone | 313-979-1010
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Fax | 313-979-1010
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 6802078416
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401017155
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License Number State | MI
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