Gibson Lane Behavioral Health Care LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GIBSON LANE BEHAVIORAL HEALTH CARE LLC

Practice address

7725 N 43Rd Ave BLDG 5
Phoenix, AZ 85051-5770

Phone

(312) 599-8267

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Lissa Sebatu

Title

Owner

Phone

(312) 599-8267

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1750024519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7725 N 43RD AVE BLDG 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850515770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 N 43RD AVE BLDG 5",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850515770",
            "telephone_number": "312-599-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GIBSON LANE BEHAVIORAL HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "SEBATU",
        "authorized_official_first_name": "LISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-599-8267"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Patrick Giblin, LMSW
• Megan E Giblin, LCSW
• Noreen Gibney, BSN
• Gibson Care LLC
• Gibson Lane Assisted Living LLC
• Gibson Surgical Assisting, PLLC
• Amanda Gibson, CRNA
• Amy Gibson, ATC LAT
• Andrew Gibson, DPT
• Colleen M Gibson, RDH

• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; 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.