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General NPI Number Information
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NPI Number | 1396116729
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Entity Type | Individual
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Provider Name | MISTY GIBSON PHD, LMHC, LCPC, LPC
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Gender | Female
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Dates
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Enumeration Date | 10/12/2015
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 1600B SW DASH POINT RD # 1017
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City | FEDERAL WAY
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State | WA
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Zip | 98023-4530
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Country | US
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Telephone | 253-201-2436
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Fax |
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Provider Business Mailing Address
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Address Line | 1600B SW DASH POINT RD # 1017
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City | FEDERAL WAY
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State | WA
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Zip | 98023-4530
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Country | US
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Telephone | 253-201-2436
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LH60819101
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License Number State | WA
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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 | 0701015332
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 60819101
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PRC200012574
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License Number State | DC
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Taxonomy #5
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 9556
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License Number State | MD
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