Individual provider Active NPI

Debra Gibbons, L.M.F.T.

  • Marriage & Family Therapist
  • St George, UT
National Provider Identifier
1467774638
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
89417013902 Issued in WA
Practice address
321 N Mall Dr. BLDG. O
101
Saint George, UT 84790-7313
Phone
(435) 868-8376
Fax
(435) 635-9720
NPI assigned
Feb 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 89417013902 WA Primary

Addresses

Primary practice location

321 N Mall Dr. BLDG. O
101
Saint George, UT 84790-7313

Mailing address

321 N Mall Dr. BLDG. O
101
Saint George, UT 84790-7313
Phone (435) 868-8376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20240703002527 UT Practitioner - Marriage and Family Therapist 4284177189 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

321 N Mall Dr
BLDG O
St George, UT 84790-7302
Phone (435) 868-8376

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
89417013902WAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Debra Gibbons LLC Marriage & Family Therapist CurrentSince Apr 20, 2024 Accepting new patients

Locations

321 N Mall Dr
Ste O101
St George, UT 84790
Phone (435) 590-1832

321 N Mall Dr
Bldg O
St George, UT 84790
Phone (435) 868-8376

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1266278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1467774638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 N MALL DR. BLDG. O",
            "address_2": "101",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907313",
            "telephone_number": "435-868-8376",
            "fax_number": "425-635-9720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MALL DR. BLDG. O",
            "address_2": "101",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847907313",
            "telephone_number": "435-868-8376",
            "fax_number": "435-635-9720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "DEBRA",
        "name_prefix": "Mrs.",
        "credential": "L.M.F.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-16",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "89417013902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.