Gregory Cecil Gibbons, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

65652 Issued in TX

Practice address

1602 W Business 380 Ste 100
Decatur, TX 76234-3267

Phone

(940) 539-8510

Fax

(940) 432-3640

NPI assigned

Jan 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1831788611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762346156",
            "telephone_number": "940-539-8510",
            "fax_number": "940-432-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W BUSINESS 380 STE 100",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343267",
            "telephone_number": "940-539-8510",
            "fax_number": "940-432-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBBONS",
        "first_name": "GREGORY",
        "middle_name": "CECIL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "65652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "8NX853",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "419691701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Elizabeth Fuller, FNP-C
• Travis James Fulton, PTA
• Future Mobility Systems of Texas , Inc.
• Mary Louise Gardner, FNP
• Guy Gregory Garrett, M.D.
• Gilbert Berdine MD
• George Keith Gill, MD
• Lea Anne Gilley, FNP-C
• Kushal Giri
• Catherine Givens

• Clinical Social Worker in Decatur, TX
• Providers in Decatur, TX by specialty
• Clinical Social Worker in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2023; 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.