Active NPI
Hubert Lee Gibson, LPC
- Mental Health Counselor
- Fayetteville, NC
National Provider Identifier
1104020601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3763
- Practice address
- 3626 Thorndike Dr
Fayetteville, NC 28311-0367 - Phone
- (910) 822-2209
- NPI assigned
- Jun 11, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3763 | NC | Primary |
Addresses
Primary practice location
3626 Thorndike Dr
Fayetteville, NC 28311-0367
Mailing address
3626 Thorndike Dr
Fayetteville, NC 28311-0367
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104020601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3626 THORNDIKE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283110367"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3626 THORNDIKE DR",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283110367",
"telephone_number": "910-822-2209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "HUBERT",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "3763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.