Gibson, Shawn
Gibson, Shawn is an sole proprietor health care provider with primary practice located at 3282 Mallard Cove Ln , Fort Wayne IN 46804-2883. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Gibson, Shawn can be contacted via phone (812) 558-0574.Contact Information
Primary practice address
3282 Mallard Cove Ln
Fort Wayne IN 46804-2883
Phone: (812) 558-0574
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 5820 | Tennessee |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 13690 | Tennessee |
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 33010944A | Indiana |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 86000400A | Indiana |
Profile Details
| NPI number | 1972241131 |
|---|---|
| LBN Legal business name | Gibson, Shawn |
| Credentials | LAC, LMSW, LPC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 26th, 2022 |
| Last updated | Feb 22nd, 2023 - 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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