NPIMap

Organization Active NPI

Gibson Ventures, LLC

Doing business as Mountain Brook Counseling

  • Mental Health Counselor
  • South Jordan, UT
National Provider Identifier
1336958735
Registry record updated Jan 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GIBSON VENTURES, LLC
Doing business as
Mountain Brook Counseling
Practice address
1218 W South Jordan Pkwy Ste A2
South Jordan, UT 84095-5946
Phone
(385) 645-8889
NPI assigned
Jan 1, 2025
Last updated
Jan 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2025

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

Authorized official

Name
Brad Gibson
Title
Owner/Manager
Phone
(801) 735-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

1218 W South Jordan Pkwy Ste A2
South Jordan, UT 84095-5946

Mailing address

15047 S Bugle Ridge Dr
Herriman, UT 84096-5722
Phone (801) 735-7555

Other names 1

  • Mountain Brook Counseling Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121001384 UT Part B Supplier - Clinic/Group Practice 6901335918 Receives reassigned benefits from 2 practitioners
Practice locations: South Jordan, UT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1735689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735689600000",
    "number": "1336958735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15047 S BUGLE RIDGE DR",
            "city": "HERRIMAN",
            "state": "UT",
            "postal_code": "840965722",
            "telephone_number": "801-735-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 W SOUTH JORDAN PKWY STE A2",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955946",
            "telephone_number": "385-645-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON VENTURES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-01",
        "last_updated": "2025-01-01",
        "certification_date": "2025-01-01",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "801-735-7555"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountain Brook Counseling",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.