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Individual
MS. BEVERLY M GIBSON
Active
Individual
MS. BEVERLY M GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC, CSW
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
44SW00330700
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00032400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37LC00032400
LCADC, CSW
NJ
01
—
44SW00330700
CSW
NJ
Enumeration date
07/16/2010
Last updated
07/16/2010
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