Stefan Gibson

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

3033 N Central Ave Ste 700
Phoenix, AZ 85012-2806

Phone

(602) 230-7373

NPI assigned

Jan 15, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1609300854
  Medicare reassignment NPD
• Denova Collaborative Health, LLC

  • Multi-Specialty Clinic/Center
  • Peoria, AZ
  • NPI 1740079060
  NPD

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

{
    "created_epoch": "1547510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1063986891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 E HIGHLAND AVE STE B200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850164741",
            "telephone_number": "602-855-0445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 N CENTRAL AVE STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122806",
            "telephone_number": "602-230-7373"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2111 E Highland Ave Ste B200",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850164741",
            "country_code": "US",
            "telephone_number": "602-855-0445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "STEFAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-15",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Gibson, LPC
• Morgan Marie Gibson
• Renee Gibson, LCSW
• Sara Gibson, LAC
• Scott Kimball Gibson
• Ruth Gichanga
• Karen Giddings
• Geoffrey Eric Gideon, DO
• Jocelyn Gidley
• Quint James Gidley

• Professional Counselor in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Professional Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; 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.