Derrick Courtney Gibson, M.S LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

1618 Issued in WV

Practice address

2 Chateau LN
Barboursville, WV 25504-1626

Phone

(304) 736-9662

Fax

(304) 733-0079

NPI assigned

Nov 5, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: derrick.gibson.1@7363.direct.athenahealth.com

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.

• Intercessory Counseling and Consulting Outreach Inc

  • Professional Counselor
  • S Charleston, WV
  • NPI 1508473141
  NPD Authorized official
• Womencare Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1447741236
  NPD (past)
• Womencare Inc

  • Federally Qualified Health Center (FQHC)
  • Charleston, WV
  • NPI 1790276525
  NPD (past)
• Womencare, Inc

  • Federally Qualified Health Center (FQHC)
  • Winfield, WV
  • NPI 1760268643
  NPD (past)

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

{
    "created_epoch": "1194220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564704000000",
    "number": "1679753842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "97 GREAT TEAYS BLVD",
            "address_2": "SUITE 6",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609815",
            "telephone_number": "304-757-6999",
            "fax_number": "304-201-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CHATEAU LN",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041626",
            "telephone_number": "304-736-9662",
            "fax_number": "304-733-0079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "116 Hills Plz",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253872438",
            "country_code": "US",
            "telephone_number": "304-720-4466",
            "fax_number": "304-720-4821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 Greenbrier St # 160",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253111007",
            "country_code": "US",
            "telephone_number": "304-400-7876",
            "fax_number": "304-720-4821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "812 Park Ave # 35",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253022524",
            "country_code": "US",
            "telephone_number": "681-265-5085",
            "fax_number": "681-265-5086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "DERRICK",
        "middle_name": "COURTNEY",
        "name_prefix": "Mr.",
        "credential": "M.S LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-05",
        "last_updated": "2019-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1618",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Elaine George
• Stephanie Nicole Gerace
• Abigail Getz
• Michael W Gibbs, MD
• Chasity Gibson
• Edie Marie Gibson
• Katelyn Gibson
• Kimberly Gibson
• Lasha Elizabeth Gibson
• Patricia Gibson

• Professional Counselor in Barboursville, WV
• Providers in Barboursville, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.