SHAWN GIBSON LAC LMSW NPI 1972241131

NPI Information

NPI: 1972241131
Provider Name: SHAWN GIBSON, LAC, LMSW
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3282 MALLARD COVE LN
FORT WAYNE, IN
ZIP 46804
Phone: (812) 558-0574
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Shawn Gibson, LAC, LMSW is an addiction (substance use disorder) counselor in Fort Wayne, IN. Shawn Gibson, LAC, LMSW NPI is 1972241131. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3282 MALLARD COVE LN
FORT WAYNE, IN
ZIP 46804-883
Phone: (812) 558-0574

The enumeration date for this NPI number is 5/26/2022 and was last updated on 5/26/2022.

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	104100000X	Social Worker		13690	TENNESSEE	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	86000400A	INDIANA	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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