Crystal Gibson, TLLP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301015538 Issued in MI

Practice address

33730 Ryan Rd
Sterling Heights, MI 48310-6302

Phone

(248) 830-7541

NPI assigned

Dec 29, 2015

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gibson Wellness Group, LLC

  • Marriage & Family Therapist
  • Troy, MI
  • NPI 1891573770

  Psychologist

  NPD
• Circle of Life Psychological Services, PC

  • Adult Mental Health Clinic/Center
  • Troy, MI
  • NPI 1851865968
  NPD (past)

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451347200000",
    "number": "1114382595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33730 RYAN RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106302",
            "telephone_number": "248-830-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33730 RYAN RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106302",
            "telephone_number": "248-830-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "CRYSTAL",
        "credential": "TLLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301015538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yarah Ghandour
• Vanessa Ghazala
• Jasmin Ghuznavi, M.D.
• David Giancola III, P.A.
• Darkeisha Gibbons
• Karen Ann Gibson, LPC
• Stephanie Ann Gierke, MOT, OTR
• Savanna Marie Gifford
• Bruno A Giglio, D.D.S.
• Vasilios Gikas, D.O.

• Psychologist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.