SHANITA GIBSON LAC NPI 1336650589

NPI Information

NPI: 1336650589
Provider Name: SHANITA GIBSON, LAC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1405 N PIERCE ST STE 101
LITTLE ROCK, AR
ZIP 72207
Phone: (501) 603-2147
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Shanita Gibson, LAC is a mental health counselor in Little Rock, AR. Shanita Gibson, LAC NPI is 1336650589. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1405 N PIERCE ST STE 101
LITTLE ROCK, AR
ZIP 72207-379
Phone: (501) 603-2147
Fax: (501) 603-0324

The enumeration date for this NPI number is 10/16/2017 and was last updated on 10/16/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	A1708254	ARKANSAS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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