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NPI Code Detail

MEDICARE: MS. JULIE ANN GIBSON MSW, LCSW

MEDICARE: MS. JULIE ANN GIBSON MSW, LCSW
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 Worker000712MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1700073202
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JULIE ANN GIBSON MSW, LCSW
Provider Business Mailing Address
First Line : 4401 NE VIVION RD
Second Line : SUITE 203
City : KANSAS CITY
State : MO
Zip : 64119-2807
Country : US
Telephone Number : 816-455-7450
Fax Number : 816-746-9850
Provider Business Practice Location Address
First Line : 4401 NE VIVION RD
Second Line : SUITE 203
City : KANSAS CITY
State : MO
Zip : 64119-2807
Country : US
Telephone Number : 816-455-7450
Fax Number : 816-746-9850
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2007
Last Update Date : 03/04/2026

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