Active NPI
Jennifer Gibney, CEIS
- Psychologist
- Brockton, MA
National Provider Identifier
1376698928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 1115 W Chestnut St
Brockton, MA 02301 - Phone
- (508) 559-0473
- Fax
- (508) 427-5361
- NPI assigned
- Jan 24, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
1115 W Chestnut St
Brockton, MA 02301
Mailing address
601 Tremont Street
Apt 3
Boston, MA 02118
Phone (617) 901-1145
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1376698928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 TREMONT STREET",
"address_2": "APT 3",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118",
"telephone_number": "617-901-1145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "508-559-0473",
"fax_number": "508-427-5361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBNEY",
"first_name": "JENNIFER",
"name_prefix": "Ms.",
"credential": "CEIS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.