Shatangela Gibbs, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401019167 Issued in MI

Practice address

7 W Square Lake Rd
Bloomfield Hills, MI 48302-0462

Phone

(248) 221-2699

NPI assigned

May 24, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Resilience and Support Counseling LLC

  • Professional Counselor
  • Bloomfield Hills, MI
  • NPI 1538769245
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1013574037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 W SQUARE LAKE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020462",
            "telephone_number": "248-221-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7 W SQUARE LAKE RD",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483020462",
            "telephone_number": "248-221-2699"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1777 Axtell Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "MI",
            "postal_code": "480844400",
            "country_code": "US",
            "telephone_number": "586-214-2720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBBS",
        "first_name": "SHATANGELA",
        "name_prefix": "Miss",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-24",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401017177",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401019167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "sgibbs@resisupportcounseling.com",
            "affiliation": "N",
            "address_1": "7 W Square Lake Rd",
            "city": "Bloomfield Hills",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483020462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• A Susan George, MD
• Raji S George, DNP, PMHNP-BC,FNP-BC
• Georgia Mental Health, Inc.
• Geropsych-at-Home
• GFZ Medical Services PLLC
• Carolyn Roe Gier, LMSW
• Marilyn K Gilbert, PHD
• Lynda S. Giles, PH.D.
• Jennifer Marie Giordano, D.O.
• Joshua Marc Gitlin, MD

• Professional Counselor in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.