Gibson, Gary Grant

Gibson, Gary Grant is an sole proprietor health care provider with primary practice located at 1351 Hershberger Rd Nw Suite 205, Roanoke VA 24012-2234. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Gibson, Gary Grant can be contacted via phone (540) 682-3498.

Contact Information

Primary practice address
1351 Hershberger Rd Nw Suite 205 Roanoke VA 24012-2234
Phone: (540) 682-3498
Fax: (540) 776-2722
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0701003993 Virginia
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 00016 Minnesota

Profile Details

NPI number 1255526174
LBN Legal business name Gibson, Gary Grant
Credentials LPC, NCC, LPCC,
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 13th, 2007
Last updated Mar 22nd, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255526174 NPPES
Virginia MEDICAID 1255526174

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