Individual provider Active NPI

Caitlin Gibb, LCSW, LMFT

  • Clinical Social Worker
  • Portland, OR
National Provider Identifier
1396497780
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L30025 Issued in OR
Practice address
1235 SE Division Strest
Suite 203B
Portland, OR 97202-1087
Phone
(805) 602-0276
NPI assigned
Jan 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X TI1411 OR
Clinical Social Worker 1041C0700X L30025 OR Primary

Addresses

Primary practice location

1235 SE Division Strest
Suite 203B
Portland, OR 97202-1087

Mailing address

4028 NE 41St Ave
Portland, OR 97212-1934
Phone (805) 602-0276

Other practice location 1

4028 NE 41st Ave
Portland, OR 97212-1934
Phone (805) 602-0276

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

State licenses

LicenseStateTypeSpecialty
L30025ORMDClinical Social Worker
TI1411ORMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1396497780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4028 NE 41ST AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972121934",
            "telephone_number": "805-602-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 SE DIVISION STREST",
            "address_2": "SUITE 203B",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972021087",
            "telephone_number": "805-602-0276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4028 NE 41st Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972121934",
            "country_code": "US",
            "telephone_number": "805-602-0276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBB",
        "first_name": "CAITLIN",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-26",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "OR",
            "license": "TI1411",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L30025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.