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Organization
KATIE GIBBONS COUNSELING LLC
Active
Organization
KATIE GIBBONS COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY KATHLEEN GIBBONS LCPC (OWNER)
(618) 406-8857
Entity
Organization
Contact information
Practice address
785 WALL ST STE 200, O FALLON, IL 62269-1959
(618) 406-8857
(618) 726-2024
Mailing address
508 CORTNER DR, SMITHTON, IL 62285-1483
(618) 406-8857
(618) 726-2024
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/01/2018
Last updated
11/01/2018
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