Troy Eldon Gibson Jr., M.A., LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180012507 Issued in IL

Practice address

3950 N Lake Shore Dr Apt 625E
Chicago, IL 60613-6447

Phone

(484) 632-9643

NPI assigned

Dec 21, 2016

Last updated

Aug 8, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 2, 2024 through Sep 2, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Center on Halsted

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
  • NPI 1508824244
  NPD

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1649715962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 N LAKE SHORE DR APT 625E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136447",
            "telephone_number": "484-632-9643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 N LAKE SHORE DR APT 625E",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606136447",
            "telephone_number": "484-632-9643"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 W Grand Ave",
            "address_2": "Ste B PMB 324489",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60612",
            "country_code": "US",
            "telephone_number": "312-298-9848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "TROY",
        "middle_name": "ELDON",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "M.A., LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-21",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "178012601",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180012507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lydia Gibson
• Meghan Gibson, LAC.
• Molly Gibson
• Roland M Gibson Jr., D.D.S
• Sandy Yevette Gibson, D.O.
• William Samuel James Gibson, MD, PHD
• Donald Giddens
• Maggie Giddens, NP
• Jacklyn M Gideon
• Jennifer Anne Gideon, P.T.

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.

Verify at the official NPI Registry.