MEDICARE: LISA MONTAGNA GIBBS LICSW

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0300010	OTHER	MA	MBHP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891958724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA MONTAGNA GIBBS LICSW

Provider Business Mailing Address
First Line	:	726 NORTH RD
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9724
Country	:	US
Telephone Number	:	413-320-2416
Fax Number	:

Provider Business Practice Location Address
First Line	:	726 NORTH RD
Second Line	:
City	:	WESTFIELD
State	:	MA
Zip	:	01085-9724
Country	:	US
Telephone Number	:	413-320-2416
Fax Number	:

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

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	05/27/2026

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