Individual
MS. BEVERLY M GIBSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC, CSW
Contact information
Practice address
68 DUNMORE AVNEUE, EWING, NJ 08618
(609) 577-9714
(608) 671-1500
Mailing address
68 DUNMORE AVE, EWING, NJ 08618-1974
(609) 577-9714
(609) 671-0015
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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