Provider Demographics
NPI:1013892165
Name:GIBBS, CASEY BRIAN (LPCC)
Entity type:Individual
Prefix:
First Name:CASEY
Middle Name:BRIAN
Last Name:GIBBS
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CANBY RD APT 108
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96003-4900
Mailing Address - Country:US
Mailing Address - Phone:530-720-3645
Mailing Address - Fax:
Practice Address - Street 1:1706 CHURN CREEK RD
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-0236
Practice Address - Country:US
Practice Address - Phone:530-891-0973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19847101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health