Carlene Dawn Gibson, MSW, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW018684 Issued in PA

Practice address

307 Market Street
Family Therapy Services
Johnstown, PA 15901-1701

Phone

(814) 254-4351

NPI assigned

Jun 13, 2008

Last updated

Aug 4, 2015By the provider in NPPES

Sex

Female

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 PA

Eligible to order & refer

• Part B services: Yes
• 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

State licenses

Practice roles

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

• Family Therapy Services

  • Clinical Social Worker
  • Johnstown, PA
  • NPI 1629512660
  NPD (past) Authorized official

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

{
    "created_epoch": "1213315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1073773990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 273",
            "address_2": "FAMILY THERAPY SERVICES",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "15907",
            "telephone_number": "814-254-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 MARKET STREET",
            "address_2": "FAMILY THERAPY SERVICES",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159011701",
            "telephone_number": "814-254-4351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CARLENE",
        "middle_name": "DAWN",
        "name_prefix": "Mrs.",
        "credential": "MSW, LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-13",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW018684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan D Giannone, M.ED.
• Giant Eagle Inc (Giant Eagle Pharmacy 0016)
• Giant Eagle Inc (Giant Eagle Pharmacy 0019)
• Giant Eagle Inc (Giant Eagle Pharmacy 0046)
• Nathan Gibb, DO
• Erin Gibson, MSW, LSW
• Jazmin Gibson
• Rebecca Gibson, DPT
• Heather A. Gides, PA-C
• James J Gides, PA-C

• Clinical Social Worker in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2015; 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.