Constace Gibson, MFT LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

CONSTACE GIBSON, MFT LLC

Doing business as

Constance Gibson, MFT

Practice address

2613 Village Side Dr
Santa Rosa, CA 95405-6849

Phone

(707) 583-9287

NPI assigned

Jul 22, 2024

Organization subpart

No

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

Authorized official

Name

Constance GibsonNPI 1083276661

Title

Owner

Phone

(707) 583-9287

Specialties & licenses 1

Addresses

Other names 1

• Constance Gibson, MFT Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Constance E Gibson, LMFT

  • Marriage & Family Therapist
  • Olympia, WA
  • NPI 1083276661
  NPD Authorized official

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

{
    "created_epoch": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1124856364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11746",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081746",
            "telephone_number": "707-583-9287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2613 VILLAGE SIDE DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056849",
            "telephone_number": "707-583-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSTACE GIBSON, MFT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-583-9287"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Constance Gibson, MFT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chloe Anne Conroy, MS OTR/L
• Pitr Gerard Conroy, MD
• Giac Donati Consiglieri, MD
• Joann Elaine Consiglieri, MFT
• Consonus Healthcare
• Stephanie Constantine, A.S.W
• Maya Contardi
• Tori Eugena Conte
• Fred W Contreras, MSN, APRN, BC FNP
• Cathy Conway, LCSW

• Community/Behavioral Health Agency in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.