Individual provider Active NPI

Breezie Jamel Gibson, PHD, LP, HSPP

  • Health Service Psychologist
  • Greenfield, IN
National Provider Identifier
1184920381
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service PsychologistTaxonomy code 103TH0100X
License
20044066A Issued in IN
Practice address
2765 Red Spruce Dr
Greenfield, IN 46140-5023
Phone
(614) 531-7330
NPI assigned
Feb 4, 2011
Last updated
Jun 29, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Psychologist 103TH0100X 20044066A IN Primary
Community Health Worker 172V00000X NU

Addresses

Primary practice location

2765 Red Spruce Dr
Greenfield, IN 46140-5023

Mailing address

2765 Red Spruce Dr
Greenfield, IN 46140-5023

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

Practice roles

OrganizationSpecialtyStatusNew patients
Total Solution Psychological and Consultation Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1296777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1184920381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2765 RED SPRUCE DR",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461405023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 RED SPRUCE DR",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461405023",
            "telephone_number": "614-531-7330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "BREEZIE",
        "middle_name": "JAMEL",
        "name_prefix": "Dr.",
        "credential": "PHD, LP, HSPP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-04",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "IN",
            "license": "20044066A",
            "primary": true
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.