Basic Information
| Provider Information | |||||||||
| NPI: | 1306900287 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GIBSON | ||||||||
| FirstName: | REBECCA | ||||||||
| MiddleName: | MORGAN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSW, LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 444 | ||||||||
| Address2: | |||||||||
| City: | MURPHY | ||||||||
| State: | NC | ||||||||
| PostalCode: | 289060444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8288370071 | ||||||||
| FaxNumber: | 8288375309 | ||||||||
| Practice Location | |||||||||
| Address1: | 1482 RUSS AVE | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287864143 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284521395 | ||||||||
| FaxNumber: | 8284521396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/21/2006 | ||||||||
| LastUpdateDate: | 09/24/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | C000046 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 1693U | 01 | NC | BCBS | OTHER | 6003009 | 05 | NC | MEDICAID |