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General NPI Number Information
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NPI Number | 1902353360
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Entity Type | Individual
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Provider Name | ALEX J GIBSON PSYD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 107 CARPENTER DRIVE SUITE 210
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City | STERLING
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State | VA
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Zip | 20164-4468
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Country | US
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Telephone | 703-297-4368
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Fax | 571-512-7955
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Provider Business Mailing Address
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Address Line | 107 CARPENTER DRIVE SUITE 210
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City | STERLING
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State | VA
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Zip | 20164-4468
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Country | US
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Telephone | 703-297-4368
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Fax | 571-512-7955
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810007662
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License Number State | VA
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