JIMMY R. GIBSON (NPI# 1093803314) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093803314 |
| Entity Type | Individual |
| Full Name | JIMMY R. GIBSON |
| Credential | LISW |
| Practice Address |
302 N Main St Carlsbad NM 88220-5896 |
| Mailing Address |
914 N Canal St Carlsbad NM 88220-5110 |
| Practice Telephone | 5758850956 |
| Practice Fax Number | 5752349854 |
| Mailing Telephone | 5758854836 |
| Mailing Fax Number | 5756280676 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-03-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
X-07673 | NM | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
1544 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ACS-DEPT OF LABOR | 611549000 | 01 |
| KY | ANTHEM BC/BS | 000000375385 | 01 |
| KY | CHA HEALTH | 1164437 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629699079 | Jimmy R Gibson Jr. | Student in an Organized Health Care Education/Training Program | 1 Brookdale Plz, Brooklyn, NY 11212-3139 | 2020-04-27 |
| Street Address |
302 N MAIN ST |
| City | CARLSBAD |
| State | NM |
| Zip Code | 88220-5896 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457786352 | Turquoise Health and Wellness, Inc. | Community/Behavioral Health | 302 N Main St, Carlsbad, NM 88220-5896 | 2013-09-10 |
| 1447525779 | Shavon Balderrama | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2012-03-20 |
| 1396014932 | Dawnell R Bourque | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2011-12-28 |
| 1184919979 | Aurora Soieraj | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2011-06-09 |
| 1225367998 | Brenda J Westfall | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-12-09 |
| 1245568823 | Jesse W. Haas | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-11-19 |
| 1336476258 | Lance Pacheco | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-11-13 |
| 1447583737 | Kerry J Lawson | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-09-17 |
| 1639402928 | Lisa J Wray | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-09-17 |
| 1396078879 | Orlando Z Garcia | Case Manager/Care Coordinator | 302 N Main St, Carlsbad, NM 88220-5896 | 2009-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083248991 | Diana P Levy | Nurse Anesthetist, Certified Registered | Carlsbad Medical Center, 2430 W Pierce St., Carlsbad, NM 88220 | 2020-02-29 |
| 1790333680 | Angela Houston | Nurse Practitioner | 202 W. Church Street, Carlsbad, NM 88220 | 2019-09-03 |
| 1265958722 | Amanda Henry | Social Worker | 3000, West Church Street, Carlsbad, NM 88220 | 2017-08-16 |
| 1952827610 | Audriana B Martinez | Physical Therapy Assistant | 1038 Pinon Ln, Carlsbad, NM 88220 | 2017-08-15 |
| 1730538265 | Amber Bojorquez | Registered Nurse | 406 N. Alameda St., Carlsbad, NM 88220 | 2016-06-06 |
| 1164887584 | Kassandra Prutsman | Specialist | 126 S. Canyon, Carlsbad, NM 88220 | 2015-12-30 |
| 1306220314 | Rocky Mountain Holdings, LLC | Ambulance | 1505 Terminal Dr, Carlsbad, NM 88220 | 2015-07-20 |
| 1578986402 | Sheryl L Dugger | Registered Nurse | 406 N. Alameda, Carlsbad, NM 88220 | 2014-01-29 |
| 1194153106 | Wellcare, Inc. | Hospice Care, Community Based | 220 S Canal St Ste B, Carlsbad, NM 88220 | 2013-10-30 |
| 1932537420 | Wellcare, Inc | Home Health | 220 S Canal St Ste A, Carlsbad, NM 88220 | 2013-10-22 |
| Find all providers in zip 88220 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679185615 | Meghan Fernandes | Social Worker | 4065 Sunnyhill Dr, Carlsbad, CA 92008-2751 | 2020-08-20 |
| 1558908194 | Vanessa Kline | Social Worker | 7975 Paseo Aliso, Carlsbad, CA 92009-9013 | 2019-12-03 |
| 1275012874 | Mandy Chuey | Social Worker | 3692 Azure Cir, Carlsbad, CA 92008-2782 | 2018-08-14 |
| 1447760996 | Collaborative Therapy, LLC | Social Worker | 2516 Marron Rd Apt 301, Carlsbad, CA 92010-8385 | 2017-10-10 |
| 1093252389 | Anna Marganska | Social Worker | 6965 El Camino Real Ste 105-611, Carlsbad, CA 92009-4100 | 2017-01-24 |
| 1770983033 | Dena Long | Social Worker | 6841 Xana Way, Carlsbad, CA 92009-6031 | 2014-08-23 |
| 1902235997 | Catherine Lamme | Social Worker | 6120 Paseo Del Norte Ste E2, Carlsbad, CA 92011-1148 | 2013-11-11 |
| 1568721207 | Rachel Lynn Freeman | Social Worker | 2100 Costa Del Mar Rd, Carlsbad, CA 92009-6823 | 2012-05-15 |
| 1861760902 | Caryn Nidelman-rosen | Social Worker | 6419 Gadwall Ct, Carlsbad, CA 92011-2784 | 2011-12-04 |
| 1821321910 | Lorene Ibbetson | Social Worker | 5315 Avenida Encinas, Suite #250, Carlsbad, CA 92008-4385 | 2009-09-08 |
| Find all providers in CARLSBAD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.