Sean Gibbs
Individual provider Active NPI Professional Counselor · Saint Louis, MO
NPI 1124583489 · NPPES record last updated Sep 16, 2020
Key facts
- NPI
- 1124583489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2016025953 (MO)
- Practice address
- 1430 Olive St Ste 400
Saint Louis, MO 63103-2303 - Phone
- (314) 206-3700
- NPI assigned
- Jan 31, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2016025953 | MO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Preferred Family Healthcare, Inc. | Past | Accepting new patients | |
| Preferred Family Healthcare, Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2016025953 | MO | Yes |
Addresses
Primary practice location
1430 Olive St Ste 400
Saint Louis, MO 63103-2303
Mailing address
1430 Olive St Ste 500
Saint Louis, MO 63103-2377
Phone (314) 206-3700
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2016025953 | Other | MO | LPC |
Other providers in Saint Louis, MO
- Brittney Chanel Gibbs
- Cynthia Ann Gibbs
- Kelli Ann Gibbs
- Molly Annora Gibbs
- Sara Anne Gibbs
- Matthew J Gibfried
- Joseph Timothy Gibian
- Caitlin Marie Gibson
- Cammy Gibson
- Carla M Gibson
All providers in Saint Louis, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.