Provider Demographics
NPI:1245102706
Name:GIBBS, WAYNE ALEXANDER
Entity type:Individual
Prefix:
First Name:WAYNE
Middle Name:ALEXANDER
Last Name:GIBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 THREEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GLEN MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19342-1757
Mailing Address - Country:US
Mailing Address - Phone:484-981-9779
Mailing Address - Fax:
Practice Address - Street 1:7 THREEWOOD DR
Practice Address - Street 2:
Practice Address - City:GLEN MILLS
Practice Address - State:PA
Practice Address - Zip Code:19342-1757
Practice Address - Country:US
Practice Address - Phone:484-981-9779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health