Individual
MRS. KRISTIN MARIE GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CACII, MAC, LPC, LAC
Contact information
Practice address
130 HUDSON ST, CHESTER, SC 29706
(803) 377-8111
(803) 581-5380
Mailing address
130 HUDSON ST, CHESTER, SC 29706-1524
(803) 377-8111
(803) 581-5380
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1901313
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
31
SC
101YA0400X
Addiction (Substance Use Disorder) Counselor
507390
SC
101YP2500X
Professional Counselor
5604
SC
Other
Enumeration date
03/05/2013
Last updated
11/14/2019
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