Active NPI
Katy Kepner Gibbs
- Professional Counselor
- Nacogdoches, TX
National Provider Identifier
1518657303
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 74859
- Practice address
- 1329 N University Dr Ste F5
Nacogdoches, TX 75961-4225 - Phone
- (936) 679-3101
- NPI assigned
- May 15, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 74859 | TX | Primary |
Addresses
Primary practice location
1329 N University Dr Ste F5
Nacogdoches, TX 75961-4225
Mailing address
955 County Road 023
Jasper, TX 75951-8388
Phone (903) 372-4295
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 14, 2024 through Feb 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74859 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cordova Counseling Services PLLC | Professional | Past | Accepting new patients |
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.
-
- Professional Counselor
- Nacogdoches, TX
- NPI 1427742196
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1518657303",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 COUNTY ROAD 023",
"city": "JASPER",
"state": "TX",
"postal_code": "759518388",
"telephone_number": "903-372-4295"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1329 N UNIVERSITY DR STE F5",
"city": "NACOGDOCHES",
"state": "TX",
"postal_code": "759614225",
"telephone_number": "936-679-3101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "KATY",
"middle_name": "KEPNER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-15",
"last_updated": "2023-05-15",
"certification_date": "2023-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "74859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Nacogdoches, TX
- Monica Lynn Gasaway
- Christopher L Gayden, D.O.
- Genoa Healthcare LLC
- Georgetown Psychotherapy, PLLC (Piney Woods Psychological Services)
- Christa Counts Gibbs, LPC
- Sarah Elizabeth Gill, M.S. CCC-SLP
- Denver Lee Glass, PT, DPT
- Kristen Ruby Glass, PT, DPT
- Virginia ---- Gleghorn, LPC
- Glory Financial Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.