Gibson Center for Behavioral Change

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2009023490 Issued in MO

Legal business name

GIBSON CENTER FOR BEHAVIORAL CHANGE

Doing business as

HillCrest Counseling Associates

Practice address

340 S Broadview St
Cape Girardeau, MO 63703-5703

Phone

(573) 332-0416

Fax

(573) 335-2698

NPI assigned

Jul 8, 2011

Organization subpart

Yes

Parent organization

GIBSON RECOVERY CENTER, INC.As reported in NPPES

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

Authorized official

Name

Ryan Essex

Title

Chief Operating Officer

Phone

(573) 803-4145

Specialties & licenses 8

Addresses

Other names 1

• HillCrest Counseling Associates Doing business as

Tax ID family

Gibson Center for Behavioral Change3 organizations share this tax ID, including this one

Part of

Gibson Center for Behavioral Change

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Gibson Center for Behavioral Change

  • Substance Abuse Rehabilitation Facility
  • Cape Girardeau, MO
  • NPI 1184774275
  NPD tax ID
• Gibson Center for Behavioral Change

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Cape Girardeau, MO
  • NPI 1679928501
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/gibson-center/r4/

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.

• Janice L Ruesler, LPC

  • Professional Counselor
  • Cape Girardeau, MO
  • NPI 1598909939
  NPD (past)

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706659200000",
    "number": "1164719373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035703",
            "telephone_number": "573-332-0416",
            "fax_number": "573-335-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 S BROADVIEW ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637035703",
            "telephone_number": "573-332-0416",
            "fax_number": "573-335-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON CENTER FOR BEHAVIORAL CHANGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GIBSON RECOVERY CENTER, INC.",
        "enumeration_date": "2011-07-08",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A",
        "authorized_official_last_name": "ESSEX",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "573-803-4145"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2009023490",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2001007821",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2004002713",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "001113",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "002005",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2002031993",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MO",
            "license": "MO2005003649",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MO",
            "license": "096892",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HillCrest Counseling Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Genoa Healthcare LLC
• Donald L. Gentle, M. D.
• P A George, MD
• Adil Ghaffar, M.D.
• Thomas Matthew Gibbons, O.D.
• Gibson Center for Behavioral Change
• Gibson Center for Behavioral Change
• Kelsey D Gibson, RD, LD
• Robert J Gile, M.D.
• Jamie Gillespie

• Mental Health Counselor in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.