Search › Indiana › 101YA0400X
Shawn Gibson, LAC, LMSW, LPC
NPI 1972241131 · on the registry since 2022 · sole proprietor
Practice
- Address
- 3282 Mallard Cove Ln
Fort Wayne, IN 46804 - Phone
- (812) 558-0574
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 101YA0400X
101YA0400X
- Also registered as
- 101YP2500X
104100000X
104100000X - Licence states on file
- TN, IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-02-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana