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General NPI Number Information
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NPI Number | 1972873669
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Entity Type | Individual
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Provider Name | NANCY LYNCH GIBSON LCPC
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Gender | Female
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 949 GORSUCH AVE
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City | BALTIMORE
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State | MD
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Zip | 21218-3602
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Country | US
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Telephone | 410-467-0675
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Fax |
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Provider Business Mailing Address
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Address Line | 7822 CROSSBAY DR
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City | SEVERN
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State | MD
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Zip | 21144-1631
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Country | US
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Telephone | 610-471-4076
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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 | LC4265
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License Number State | MD
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