Provider Demographics
NPI:1124451638
Name:GIBSON, CHRISTIE WHEAT (LMFT)
Entity type:Individual
Prefix:MRS
First Name:CHRISTIE
Middle Name:WHEAT
Last Name:GIBSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-1806
Mailing Address - Country:US
Mailing Address - Phone:205-210-8099
Mailing Address - Fax:
Practice Address - Street 1:2720 7TH ST
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-1806
Practice Address - Country:US
Practice Address - Phone:205-210-8099
Practice Address - Fax:205-248-2254
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL425106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-74803OtherBLUE CROSS BLUE SHIELD
AL1124451638OtherAMERICAN BEHAVIORAL