Active NPI
Sean Gibbs, PSY.D
- Clinical Psychologist
- Metairie, LA
National Provider Identifier
1770617490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1492
- Practice address
- 3616 S I 10 Service Rd W Ste 200
Metairie, LA 70001-1874 - Phone
- (504) 838-5424
- Fax
- (504) 838-5714
- NPI assigned
- Mar 15, 2007
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | |||
| Rehabilitation Practitioner | 225400000X | IMF49880 | CA | |
| Clinical Psychologist | 103TC0700X | 1492 | LA | Primary |
Addresses
Primary practice location
3616 S I 10 Service Rd W Ste 200
Metairie, LA 70001-1874
Mailing address
1202 Monroe St
Gretna, LA 70053-2307
Phone (504) 309-6798
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1492 | LA | MD | Addiction (Substance Use Disorder) Counselor |
| IMF49880 | CA | MD | Rehabilitation Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554336000000",
"number": "1770617490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 MONROE ST",
"city": "GRETNA",
"state": "LA",
"postal_code": "700532307",
"telephone_number": "504-309-6798",
"fax_number": "504-407-2115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3616 S I 10 SERVICE RD W STE 200",
"city": "METAIRIE",
"state": "LA",
"postal_code": "700011874",
"telephone_number": "504-838-5424",
"fax_number": "504-838-5714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBBS",
"first_name": "SEAN",
"credential": "PSY.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2019-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "IMF49880",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "LA",
"license": "1492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Metairie, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.