Daniel Glen Gibson, PSY.D., M.A., M.S.W.
Individual provider Active NPI Clinical Psychologist · Meridian, ID
NPI 1194075994 · NPPES record last updated May 31, 2019
Key facts
- NPI
- 1194075994
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PSY-203026 (ID)
- Practice address
- 850 E Franklin Rd Ste 404
Meridian, ID 83642 - Phone
- (208) 258-7917
- Fax
- (208) 417-3088
- NPI assigned
- Sep 19, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
850 E Franklin Rd
Suite 402
Meridian, ID 83642-8917
Phone (208) 258-7917
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190716002282 | ID | Practitioner - Clinical Psychologist | 9537494398 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| GPS Psychology & Anxiety Clinic, LLC | Current |
Accepting new patients | |
| Jangula Cox Counseling LLC | Past | Accepting new patients |
Locations
850 E Franklin Rd
Ste 404
Meridian, ID 83642
Phone (208) 258-7917
850 E Franklin Rd
Ste 402
Meridian, ID 83642
Phone (208) 258-7917
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-203026 | ID | Yes |
Addresses
Primary practice location
850 E Franklin Rd Ste 404
Meridian, ID 83642
Mailing address
850 E Franklin Rd Ste 404
Meridian, ID 83642-8917
Phone (208) 258-7917
Other practice location 1
850 E Franklin Rd Ste 404
Meridian, ID 83642
Phone (208) 258-7917
Other providers in Meridian, ID
- Alice Giard
- Baridomaka Esther Giasi
- Gibb Anesthesia
- Justin R Gibb
- Scott H Gibbons
- Mary Lucia Gibson
- Stephen Gibson
- Salome Waitherero Gichuru
- Maycee Gielow
- Austin Giesige
All providers in Meridian, ID · Clinical Psychologist in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 31, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.