Provider Demographics
NPI:1538843271
Name:GIBSON, JUSTIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:
Last Name:GIBSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N LOGAN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3186
Mailing Address - Country:US
Mailing Address - Phone:303-834-1026
Mailing Address - Fax:
Practice Address - Street 1:950 N LOGAN ST STE 101
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-3186
Practice Address - Country:US
Practice Address - Phone:303-834-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-13
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSYC.00015821103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist