Active NPI
Cameron Damichael Gibson, LPC
- Professional Counselor
- Prosper, TX
National Provider Identifier
1720892292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 92171
- Practice address
- 805 E 1St St
Prosper, TX 75078-2919 - Phone
- (469) 481-6965
- NPI assigned
- Feb 5, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 92171 | TX | |
| Mental Health Counselor | 101YM0800X | 92171 | TX | |
| Professional Counselor | 101YP2500X | 92171 | TX | Primary |
Addresses
Primary practice location
805 E 1St St
Prosper, TX 75078-2919
Mailing address
1504 Trailwood Ter
Aubrey, TX 76227-2962
Phone (214) 475-3267
Other practice location 1
3535 Victory Group Way
Frisco, TX 75034-6719
Phone (469) 287-5502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 29, 2026 through Jan 29, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92171 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1720892292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1504 TRAILWOOD TER",
"city": "AUBREY",
"state": "TX",
"postal_code": "762272962",
"telephone_number": "214-475-3267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 E 1ST ST",
"city": "PROSPER",
"state": "TX",
"postal_code": "750782919",
"telephone_number": "469-481-6965"
}
],
"practiceLocations": [
{
"address_1": "3535 Victory Group Way",
"address_purpose": "LOCATION",
"city": "Frisco",
"state": "TX",
"postal_code": "750346719",
"country_code": "US",
"telephone_number": "469-287-5502",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GIBSON",
"first_name": "CAMERON",
"middle_name": "DAMICHAEL",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-02-05",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "92171",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "92171",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "92171",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prosper, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.