Cletus Gibbs

Individual provider Active NPI Mental Health Counselor · Frederick, OK

NPI 1275992802 · NPPES record last updated Feb 10, 2016

Key facts

NPI
1275992802
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1500 North Main
Frederick, OK 73542
Phone
(580) 335-3320
NPI assigned
Feb 10, 2016
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Yes

Addresses

Primary practice location

1500 North Main
Frederick, OK 73542

Mailing address

1625 N 13TH St
Apartment 8
Frederick, OK 73542-1433
Phone (580) 210-8215

Other providers in Frederick, OK

All providers in Frederick, OK · Mental Health Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.