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NPI Code Detail

MEDICARE: MS. DEBRA N GIBSON LCSW, LCADC, MHS

MEDICARE:  MS. DEBRA N GIBSON  LCSW, LCADC, MHS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00154800NJ
2101YM0800XMental Health CounselorS-4343NJ
31041C0700XClinical Social Worker44SC01015100NJ

General Provider Information

NPI Number : 1861799694
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA N GIBSON LCSW, LCADC, MHS
Provider Business Mailing Address
First Line : 2810 MORRIS AVE STE 209
Second Line :
City : UNION
State : NJ
Zip : 07083-4841
Country : US
Telephone Number : 908-349-8760
Fax Number : 908-349-8092
Provider Business Practice Location Address
First Line : 2810 MORRIS AVE STE 209
Second Line :
City : UNION
State : NJ
Zip : 07083-4841
Country : US
Telephone Number : 908-349-8760
Fax Number : 908-349-8092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2011
Last Update Date : 02/14/2011

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Directions to “ MS. DEBRA N GIBSON LCSW, LCADC, MHS” Practice Location

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