Marcia Susan Gibson, PSY.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071.007322 Issued in IL

Practice address

404 W Boughton Rd Ste B
Bolingbrook, IL 60440-1898

Phone

(630) 759-1732

NPI assigned

Aug 28, 2007

Sex

Female

Sole proprietor

No

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Marcia S. Gibson, Psy.D and Associates, P. C.Group PAC ID 2365577160, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Marcia S. Gibson, Psy.D and Associates, P. C..

  • Adolescent and Children Mental Health Clinic/Center
  • Bolingbrook, IL
  • NPI 1881922284

  IL

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1346434883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 W BOUGHTON RD STE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401898",
            "telephone_number": "630-759-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 W BOUGHTON RD STE B",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604401898",
            "telephone_number": "630-759-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "MARCIA",
        "middle_name": "SUSAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071.007322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl F Geipel, DC
• Gentle Solutions Counseling PLLC
• George Alamir DDS Ms and Associates LTD
• Elaine Gerhard, CCC-SLP
• Gianan Health PLLC
• Brooke Gilbertson, OTR/L, MOT
• Kimberly Ginter, CRNA
• Courtney Lynn Gleason, M.S., CF-SLP
• Radha Godambe, PT. DPT
• Alejandra Godines, PTA

• All providers in Bolingbrook, IL
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.