Individual provider Active NPI

Gregory Scott Gibson, MA, LPCC

  • Mental Health Counselor
  • Santa Fe, NM
National Provider Identifier
1013940642
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0151831 Issued in NM
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

Updated by the provider on Jan 9, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
0151831NMMDMental Health Counselor
11071AZMDProfessional 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.

Verify at the official NPI Registry.