Provider Demographics
NPI:1033884101
Name:GIBLIN, CAROLINE BARKER (LLPC)
Entity type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:BARKER
Last Name:GIBLIN
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2528 W WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-6921
Mailing Address - Country:US
Mailing Address - Phone:989-832-0191
Mailing Address - Fax:989-486-9413
Practice Address - Street 1:2528 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6921
Practice Address - Country:US
Practice Address - Phone:989-859-7633
Practice Address - Fax:989-486-9413
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451019404101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6451019404Other15180792