Provider Demographics
NPI:1528465440
Name:GIBBONS, LEAH (MS, CHC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:GIBBONS
Suffix:
Gender:F
Credentials:MS, CHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120B KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1630
Mailing Address - Country:US
Mailing Address - Phone:941-224-6256
Mailing Address - Fax:
Practice Address - Street 1:120B KINGSTON DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-1630
Practice Address - Country:US
Practice Address - Phone:941-224-6256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No101Y00000XBehavioral Health & Social Service ProvidersCounselor