Active NPI
Haley Gibson, LMFT
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1407604259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 162595
- Practice address
- 3434 Mendocino Ave # a
Santa Rosa, CA 95403-2274 - Phone
- (707) 284-1978
- Fax
- (707) 708-2188
- NPI assigned
- May 7, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 162595 | CA | Primary |
Addresses
Primary practice location
3434 Mendocino Ave # a
Santa Rosa, CA 95403-2274
Mailing address
615 Healdsburg Ave Unit 221
Santa Rosa, CA 95401-5168
Phone (925) 282-0402
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
| License | State | Type | Specialty |
|---|---|---|---|
| 162595 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonoma County Child & Family Counseling, Inc. | Past | Accepting new patients | |
| Sonoma County Child & Family Counseling, Inc. | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Marriage & Family Therapist
- Santa Rosa, CA
- NPI 1639617699
-
- Community/Behavioral Health Agency
- Santa Rosa, CA
- NPI 1689195216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1776038400000",
"number": "1407604259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 HEALDSBURG AVE UNIT 221",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015168",
"telephone_number": "925-282-0402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3434 MENDOCINO AVE # A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032274",
"telephone_number": "707-284-1978",
"fax_number": "707-708-2188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "HALEY",
"name_prefix": "Mrs.",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-07",
"last_updated": "2026-04-13",
"certification_date": "2026-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "162595",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.