MEDICARE: TICHANA GIBBS LPC

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
1	101YM0800X	Mental Health Counselor	84737	TX

General Provider Information

NPI Number	:	1346928264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TICHANA GIBBS LPC

Provider Business Mailing Address
First Line	:	550 N CENTRAL EXPY UNIT 2282
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-0122
Country	:	US
Telephone Number	:	281-810-8483
Fax Number	:

Provider Business Practice Location Address
First Line	:	5301 ALPHA RD STE 80
Second Line	:	#6012
City	:	DALLAS
State	:	TX
Zip	:	75240-4393
Country	:	US
Telephone Number	:	281-810-8483
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	11/27/2024

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Directions to “ TICHANA GIBBS LPC” Practice Location

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