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Nicole Marie Gibson, CASAC-T
Adult Mental Health Clinic/Center in Syracuse, New York
NPI 1114438611

Nicole Marie Gibson is an Adult Mental Health Clinic/Center based in Syracuse, NY and is specialized in Adult Mental Health. Nicole Marie Gibson practices in Syracuse, NY and has the professional credentials of CASAC-T. The NPI Number for Nicole Marie Gibson is 1114438611 and holds a License No. 31404 (New York).

The current practice location address for Nicole Marie Gibson is 321 W Onondaga St, Syracuse, NY and can be reached out via phone at 315-478-0610. You can also correspond with Nicole Marie Gibson through the mailing address at 133 MCKINLEY AVE, SYRACUSE, NY - 13205-1513 (mailing address contact number: ).

Location: 321 W Onondaga St, Syracuse, NY, 13205-1513
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1114438611
Provider Name
Nicole Marie Gibson
Credential
CASAC-T
Provider Entity Type
Individual
Gender
Female
Address
321 W Onondaga St, Syracuse, NY, 13205-1513
Phone Number
315-478-0610
Fax Number
Provider Enumeration Date
10/24/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
321 W Onondaga St
City
Syracuse
State
New York
Zip
13202-3207
Phone Number
315-478-0610
Fax Number
person
Provider Business Mailing Address Details
Address
321 W Onondaga St
City
Syracuse
State
New York
Zip
13202-3207
Phone Number
315-478-0610
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Mental Health
Taxonomy
261QM0850X
License No.
31404 (New York)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.
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