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General NPI Number Information
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NPI Number | 1861059628
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Entity Type | Individual
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Provider Name | ALETA GIBBS PHD, LPC, LSATP
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Gender | Female
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Dates
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Enumeration Date | 05/28/2019
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 620 COUNTY LINE RD
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City | BASSETT
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State | VA
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Zip | 24055-5157
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Country | US
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Telephone | 276-732-8111
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Fax |
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Provider Business Mailing Address
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Address Line | 620 COUNTY LINE RD
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City | BASSETT
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State | VA
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Zip | 24055-5157
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Country | US
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Telephone | 276-790-7497
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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 | 0701011490
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0718000532
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0701011490
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License Number State | VA
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