Active NPI
Heidi A Gibbons, LCSW
- Clinical Social Worker
- Janesville, WI
National Provider Identifier
1336299478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7154-123
- Practice address
- 3506 N US Highway 51
Janesville, WI 53545-0726 - Phone
- (608) 757-5859
- NPI assigned
- Jan 11, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7154-123 | WI | Primary |
Addresses
Primary practice location
3506 N US Highway 51
Janesville, WI 53545-0726
Mailing address
508 Church St
Clinton, WI 53525-9493
Phone (608) 290-0842
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40990700 | Medicaid | WI |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7154-123 | WI | MD | Clinical Social Worker |
| 7154 | WI | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295481600000",
"number": "1336299478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 CHURCH ST",
"city": "CLINTON",
"state": "WI",
"postal_code": "535259493",
"telephone_number": "608-290-0842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3506 N US HIGHWAY 51",
"city": "JANESVILLE",
"state": "WI",
"postal_code": "535450726",
"telephone_number": "608-757-5859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBONS",
"first_name": "HEIDI",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-11",
"last_updated": "2011-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7154-123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40990700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Janesville, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.