Provider Demographics
NPI:1699558163
Name:GIBSON, KATHERINE (MA, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:GIBSON
Suffix:
Gender:F
Credentials:MA, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-3026
Mailing Address - Country:US
Mailing Address - Phone:423-756-2894
Mailing Address - Fax:423-756-2899
Practice Address - Street 1:1815 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3026
Practice Address - Country:US
Practice Address - Phone:423-756-2894
Practice Address - Fax:423-756-2899
Is Sole Proprietor?:No
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health