Individual provider Active NPI

Amber Sue Gibson, LCPC

  • Mental Health Counselor
  • Great Falls, MT
National Provider Identifier
1760990022
Registry record updated Jan 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
29486 Issued in MT
Practice address
915 1St Ave S
Great Falls, MT 59401-3705
Phone
(406) 761-2100
Fax
(406) 791-9629
NPI assigned
Jan 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 29486 MT Primary

Addresses

Primary practice location

915 1St Ave S
Great Falls, MT 59401-3705

Mailing address

PO Box 3089
Great Falls, MT 59403-3089
Phone (406) 761-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820002762 IN Practitioner - Mental Health Counselor 5890233944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29486MTMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bowen Health Inc Current Accepting new patients
Bowen Health Inc CurrentSince Aug 2, 2024 Accepting new patients
Center for Mental Health Mental Health PastSince Jun 18, 2016 Accepting new patients
Center for Mental Health Past Accepting new patients

Locations

2100 Goshen Rd
Fort Wayne, IN 46808
Phone (260) 471-3500

201 E Rudisill Blvd
Ste 106
Fort Wayne, IN 46806
Phone (260) 471-0082

2621 E Jefferson St
Warsaw, IN 46580
Phone (574) 269-0573

850 N Harrison St
Warsaw, IN 46580
Phone (219) 267-7169

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1516320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516320000000",
    "number": "1760990022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3089",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594033089",
            "telephone_number": "406-761-2100",
            "fax_number": "406-791-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 1ST AVE S",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013705",
            "telephone_number": "406-761-2100",
            "fax_number": "406-791-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "AMBER",
        "middle_name": "SUE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-19",
        "last_updated": "2018-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "29486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.