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NPI Code Detail

MEDICARE: ANGELA GIBSON, LCSW COUNSELING AND PSYCHOTHERAPY LLC

MEDICARE: ANGELA GIBSON, LCSW COUNSELING AND PSYCHOTHERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1003743659
Entity Type Code : Organization
Provider Name (Legal Business Name) : ANGELA GIBSON, LCSW COUNSELING AND PSYCHOTHERAPY LLC
Provider Business Mailing Address
First Line : 1901 ULMERTON RD. SUITE 625 #3016
Second Line :
City : CLEARWATER
State : FL
Zip : 33762
Country : US
Telephone Number : 727-628-7449
Fax Number : 727-628-7450
Provider Business Practice Location Address
First Line : 13658 PLEASANT DR
Second Line :
City : LARGO
State : FL
Zip : 33774-4126
Country : US
Telephone Number : 727-628-7449
Fax Number : 727-628-7450
Authorized Official
Title or Position : OWNER
Name : MS. ANGELA J GIBSON
Credential : LCSW
Telephone Number : 727-628-7449
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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