Gibbons, Heidi A

Gibbons, Heidi A is an individual health care provider with primary practice located at 3506 N Us Highway 51 , Janesville WI 53545-0726. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Gibbons, Heidi A can be contacted via phone (608) 757-5859.

Contact Information

Primary practice address
3506 N Us Highway 51 Janesville WI 53545-0726
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 7154-123 Wisconsin

Profile Details

NPI number 1336299478
LBN Legal business name Gibbons, Heidi A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Jan 20th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336299478 NPPES
Wisconsin MEDICAID 40990700

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