Individual provider · Type 1 NPI
Shawn Gibson, LAC, LMSW, LPC
Addiction (Substance Use Disorder) Counselor · Fort Wayne, IN
NPI number
1972241131
Active
Practice location
3282 Mallard Cove Ln
Fort Wayne, IN 46804-2883
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor | 101YP2500X | 5820 (TN) |
| Social Worker | 104100000X | 13690 (TN) |
| Social Worker | 104100000X | 33010944A (IN) |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 86000400A (IN) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
2 other providers at this address
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About NPI 1972241131
Shawn Gibson, LAC, LMSW, LPC's National Provider Identifier is 1972241131, issued on May 26, 2022. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Fort Wayne, IN. The record was last updated on Feb 22, 2023.