Doctor Name: | MR. SCOTT C GIBSON |
NPI Number: | 1033164629 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W., L.C.S.W. |
License Number: | |
Business Practice Address: | 1531 S Grove Ave Suite 204 Barrington, IL - 600105211 |
Business Phone Number: | 8473812700 |
Business Fax Number: | |
Mailing Address: | 1531 S Grove Ave, Suite 204 BARRINGTON |
State: | IL |
Postal Code: | 600105211 |
Phone Number: | 8473812700 |
Fax Number: | |
NPI Enumeration Date: | 05/23/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |