Active NPI
Bobby Gibson, L.P.C.
- Professional Counselor
- Tyler, TX
National Provider Identifier
1275882201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 16171
- Practice address
- 401 East Front Street, Ste 233
Tyler, TX 75702 - Phone
- (214) 876-4216
- NPI assigned
- Sep 6, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 16171 | TX | Primary |
Addresses
Primary practice location
401 East Front Street, Ste 233
Tyler, TX 75702
Mailing address
401 East Front Street, Ste 233
Tyler, TX 75702
Phone (214) 876-4216
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16171 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346889600000",
"number": "1275882201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 EAST FRONT STREET, STE 233",
"city": "TYLER",
"state": "TX",
"postal_code": "75702",
"telephone_number": "214-876-4216"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 EAST FRONT STREET, STE 233",
"city": "TYLER",
"state": "TX",
"postal_code": "75702",
"telephone_number": "214-876-4216"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "BOBBY",
"credential": "L.P.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-06",
"last_updated": "2012-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "16171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.