Paul K. Gibson, MC, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT-10254 Issued in AZ

Practice address

3920 S Rural Rd Ste 112
Tempe, AZ 85282-5500

Phone

(480) 428-2944

Fax

(480) 680-5361

NPI assigned

Feb 8, 2016

Last updated

Dec 22, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Marriage and Family Therapist

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aj Southwest Ventures IncGroup PAC ID 8224480090, 7 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aj Southwest Ventures Inc

  dba reVIBE Mental Health

  • Marriage & Family Therapist
  • Tempe, AZ
  • NPI 1639880917
  Medicare reassignment Care Compare group NPD
• Aj Southwest Ventures Inc

  dba reVIBE Mental Health

  • Marriage & Family Therapist
  • Tempe, AZ
  • NPI 1164233417
  NPD

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703203200000",
    "number": "1427416387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 S RURAL RD STE 112",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825500",
            "telephone_number": "480-428-2944",
            "fax_number": "480-680-5361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S RURAL RD STE 112",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825500",
            "telephone_number": "480-428-2944",
            "fax_number": "480-680-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PAUL",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "MC, LMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-08",
        "last_updated": "2023-12-22",
        "certification_date": "2023-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "AZ",
            "license": "LMFT-10254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "346214",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Selange Giannetto
• Brendan Kevin Gibbons, RN
• Mary Lynne Wilkins Giberson
• Jennifer Gibler, P.A.-C
• Megan Gibson, LM
• George Scott Gieszl Jr., MD
• Gila Internal Medicine & Geriatric P C
• Ann Rae Gilan, M.S. SLP
• Sally Anne Gilbert, PT
• Mary Elizabeth Gill, LMSW

• Marriage & Family Therapist in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Marriage & Family Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.