Paula W Gibson, PSYCHOLOGIST

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2738-57 Issued in WI

Practice address

3970 N Oakland Ave
Suite 502
Shorewood, WI 53211-2265

Phone

(414) 962-9909

NPI assigned

Feb 2, 2007

Sex

Female

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1588702203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8340 W FOND DU LAC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532184300",
            "telephone_number": "414-462-8979",
            "fax_number": "414-462-8985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 N OAKLAND AVE",
            "address_2": "SUITE 502",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532112265",
            "telephone_number": "414-962-9909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "PAULA",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WI",
            "license": "2738-57",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40993600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "W12670",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lori Ann Garfinkel, PSYD, LPC
• Magdalene Mae Garvey, LPC
• Matt Eliot George, M.S., LPC-IT, SAC-IT
• Mary Ellen Gerber, LCSW
• Gfi Radiology Inc
• Laura Christine Gillis, L.AC.
• Sarah E Girvan, RN
• Kirk Gorbach Jr., BCBA
• Karen Gottlieb, LPC
• Joanne Graham, PHD

• Psychologist in Shorewood, WI
• Providers in Shorewood, WI by specialty
• Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.