Heather Lynn Gibson, M.A, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

97630 Issued in CA

Practice address

5480 Baltimore Dr
Suite 250
La Mesa, CA 91942-2020

Phone

(619) 733-6414

NPI assigned

Jan 3, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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

• Jennifer Lundy Family Therapy, Inc.

  dba Positive Change Counseling Center

  • Clinical Psychologist
  • La Mesa, CA
  • NPI 1427320605

  Marriage & Family Therapist

  NPD (past)

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1295270080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8148 GENESEE AVE APT 88",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221467",
            "telephone_number": "858-247-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 BALTIMORE DR",
            "address_2": "SUITE 250",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919422020",
            "telephone_number": "619-733-6414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "HEATHER",
        "middle_name": "LYNN",
        "credential": "M.A, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "97630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• GHC of la Mesa, LLC (Arbor Hills Nursing Center)
• Indushree Ghosh, M.D.
• Pia Giambruno, IMF
• Rachel Michelle Gianfortune, M.D.
• Lizzie C. Giangreco, M.D.
• Teresa Grace Gieszl, NP
• Nicole Ariel Gilbert, LCSW
• Erik O. Gilbertson, M.D.
• Nathan Scott Gilbreth
• Gregory Edward Giles, O.D.

• Marriage & Family Therapist in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.