NPIMap

Organization Active NPI

T.a.V.E.R.N. Health and Wellness, LLC

  • Mental Health Counselor
  • Kirkwood, MO
National Provider Identifier
1811534647
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
T.A.V.E.R.N. HEALTH AND WELLNESS, LLC
Doing business as
Gayla Gibson
Practice address
11042 Manchester Rd
Kirkwood, MO 63122-1244
Phone
(314) 385-9550
NPI assigned
Nov 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Authorized official

Name
Gayla R Gibson, MA, LPCNPI 1780983338
Title
Therapist
Phone
(314) 385-9550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary
Nutrition Education NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133NN1002X
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X

Addresses

Primary practice location

11042 Manchester Rd
Kirkwood, MO 63122-1244

Mailing address

5517 Albia Terr
Jennings, MO 63136-1222
Phone (314) 385-9550

Other names 1

  • Gayla Gibson Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1574812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574812800000",
    "number": "1811534647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5517 ALBIA TERR",
            "city": "JENNINGS",
            "state": "MO",
            "postal_code": "631361222",
            "telephone_number": "314-385-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11042 MANCHESTER RD",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631221244",
            "telephone_number": "314-385-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T.A.V.E.R.N. HEALTH AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-27",
        "last_updated": "2019-11-27",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "GAYLA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "314-385-9550",
        "authorized_official_credential": "MA, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gayla Gibson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 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.