Gibson, Sidney Lanier

Gibson, Sidney Lanier is an sole proprietor health care provider with primary practice located at 4107 W Spruce St Ste 100 , Tampa FL 33607-2346. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Gibson, Sidney Lanier can be contacted via phone (813) 636-8811.

Contact Information

Primary practice address
4107 W Spruce St Ste 100 Tampa FL 33607-2346
Phone: (813) 636-8811
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MH0000122 Florida

Profile Details

NPI number 1619929536
LBN Legal business name Gibson, Sidney Lanier
Credentials LMHC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2006
Last updated Nov 30th, 2021 - about 3 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 1619929536 NPPES
Florida MEDICAID 007368100

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