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NPI Code Detail

MEDICARE: DR. DONNA M GIBSON PHD, LPC, NCC

MEDICARE:  DR. DONNA M GIBSON  PHD, LPC, NCC
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
1101YP2500XProfessional Counselor0701005957VA

General Provider Information

NPI Number : 1720865843
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONNA M GIBSON PHD, LPC, NCC
Provider Business Mailing Address
First Line : 14812 CREEKBROOK TER
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23113-2672
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 14812 CREEKBROOK TER
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23113-2672
Country : US
Telephone Number : 803-603-4699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2023
Last Update Date : 09/12/2023

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Directions to “ DR. DONNA M GIBSON PHD, LPC, NCC” Practice Location

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