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Individual
SHAWN GIBSON
Active
Individual
SHAWN GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LMSW, LPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
86000400A
IN
101YP2500X
Professional Counselor
5820
TN
104100000X
Social Worker
13690
TN
104100000X
Social Worker
33010944A
IN
Other
Enumeration date
05/26/2022
Last updated
02/22/2023
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