Individual
BRADLEY GIBBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
1060 W 10TH ST STE 300, ROLLA, MO 65401-2905
(844) 853-8937
Mailing address
10025 CEDAR RIDGE DR, ROLLA, MO 65401-7762
(573) 247-3818
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
MO
101YM0800X
Mental Health Counselor
Primary
2024029145
MO
101YM0800X
Mental Health Counselor
—
MO
101YP2500X
Professional Counselor
—
MO
Other
Enumeration date
05/04/2024
Last updated
07/08/2025
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