| Doctor Name: | JULIE GIBSON |
| NPI Number: | 1164563540 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 322 N Main St Kokomo, IN - 469014622 |
| Business Phone Number: | 7654538238 |
| Business Fax Number: | |
| Mailing Address: | 6626 E 75th Street, Suite 500 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462502890 |
| Phone Number: | 3176217561 |
| Fax Number: | 3173556096 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 03/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |