Organization
GIBSON CENTER FOR BEHAVIORAL CHANGE
Active
Parent organization
GIBSON RECOVERY CENTER, INC.
Other names
HillCrest Counseling Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
GIBSON RECOVERY CENTER, INC.
Authorized official
RYAN ESSEX (CHIEF OPERATING OFFICER)
(573) 803-4145
Entity
Organization
Contact information
Practice address
340 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5703
(573) 332-0416
(573) 335-2698
Mailing address
340 S BROADVIEW ST, CAPE GIRARDEAU, MO 63703-5703
(573) 332-0416
(573) 335-2698
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
001113
MO
101YM0800X
Mental Health Counselor
002005
MO
101YM0800X
Mental Health Counselor
2001007821
MO
101YM0800X
Mental Health Counselor
2004002713
MO
101YM0800X
Mental Health Counselor
Primary
2009023490
MO
1041C0700X
Clinical Social Worker
2002031993
MO
2084P0800X
Psychiatry Physician
MO2005003649
MO
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
096892
MO
Other
Enumeration date
07/08/2011
Last updated
01/31/2024
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