Individual provider Active NPI

Sarah Elizabeth Gibson, MA, LPC, CACII

  • Professional Counselor
  • Boulder, CO
National Provider Identifier
1124519426
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0013406 Issued in CO
Practice address
3400 Table Mesa Dr
Boulder, CO 80305-5869
Phone
(720) 947-9176
NPI assigned
May 22, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X ACB.0007948 CO
Professional Counselor 101YP2500X LPC.0013406 CO Primary

Addresses

Primary practice location

3400 Table Mesa Dr
Boulder, CO 80305-5869

Mailing address

737 29TH St Ste 102
Boulder, CO 80303-2317
Phone (720) 947-9176

Other practice location 1

737 29th St Ste 102
Boulder, CO 80303-2317
Phone (720) 947-9176

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
ACB.0007948COMDAddiction (Substance Use Disorder) Counselor
LPC.0013406COMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1526947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1124519426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 29TH ST STE 102",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803032317",
            "telephone_number": "720-947-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 TABLE MESA DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803055869",
            "telephone_number": "720-947-9176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "737 29th St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803032317",
            "country_code": "US",
            "telephone_number": "720-947-9176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "MA, LPC, CACII",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CO",
            "license": "ACB.0007948",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0013406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.