Provider Demographics
NPI:1902173123
Name:GIBBS, ERICA CHRISTINE (LPC)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:CHRISTINE
Last Name:GIBBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:CHRISTINE
Other - Last Name:WETTERHUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:22214 D ST
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:KS
Mailing Address - Zip Code:67156-7376
Mailing Address - Country:US
Mailing Address - Phone:620-442-4540
Mailing Address - Fax:620-442-4559
Practice Address - Street 1:22214 D ST
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:KS
Practice Address - Zip Code:67156-7376
Practice Address - Country:US
Practice Address - Phone:620-442-4540
Practice Address - Fax:620-442-4559
Is Sole Proprietor?:No
Enumeration Date:2011-11-17
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2221101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional