Active NPI
Corey L. Gibson, M.A.
- Professional Counselor
- Longview, TX
National Provider Identifier
1891037784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 67323
- Practice address
- 1705 Judson Rd Ste 103-a
Longview, TX 75601-2938 - Phone
- (903) 238-9050
- NPI assigned
- Mar 19, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 67323 | TX | Primary |
Addresses
Primary practice location
1705 Judson Rd Ste 103-a
Longview, TX 75601-2938
Mailing address
1705 Judson Rd Ste 103-a
Longview, TX 75601-2938
Phone (903) 238-9050
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)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 67323 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1891037784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 JUDSON RD STE 103-A",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756012938",
"telephone_number": "903-238-9050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1705 JUDSON RD STE 103-A",
"city": "LONGVIEW",
"state": "TX",
"postal_code": "756012938",
"telephone_number": "903-238-9050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "COREY",
"middle_name": "L.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-19",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "67323",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Longview, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.