Active NPI
Gregory Scott Gibson, MA, LPCC
- Mental Health Counselor
- Santa Fe, NM
National Provider Identifier
1013940642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0151831
- Practice address
- 2204 Brothers Rd
Suite B
Santa Fe, NM 87505-6975 - Phone
- (505) 982-6728
- Fax
- (505) 982-6728
- NPI assigned
- Jul 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 11071 | AZ | |
| Mental Health Counselor | 101YM0800X | 0151831 | NM | Primary |
Addresses
Primary practice location
2204 Brothers Rd
Suite B
Santa Fe, NM 87505-6975
Mailing address
2204 Brothers Rd
Suite B
Santa Fe, NM 87505-6975
Phone (505) 982-6728
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0151831 | NM | MD | Mental Health Counselor |
| 11071 | AZ | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420761600000",
"number": "1013940642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2204 BROTHERS RD",
"address_2": "SUITE B",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875056975",
"telephone_number": "505-982-6728",
"fax_number": "505-982-6728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2204 BROTHERS RD",
"address_2": "SUITE B",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875056975",
"telephone_number": "505-982-6728",
"fax_number": "505-982-6728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "GREGORY",
"middle_name": "SCOTT",
"name_prefix": "Mr.",
"credential": "MA, LPCC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-08",
"last_updated": "2015-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "11071",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NM",
"license": "0151831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.