Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Marie Gibson, CASAC-T

Individual provider Adult Mental Health Clinic/Center · NPI 1114438611

Nicole Marie Gibson, CASAC-T is an Adult Mental Health Clinic/Center in Syracuse, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2017
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Practice location Address checks out

321 W Onondaga St
Syracuse, NY 13202-3207
Phone: (315) 478-0610
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Mental Health Clinic/Center (primary) Taxonomy 261QM0850X · Licence 31404 (NY)

Record details

NPI number1114438611
Entity typeIndividual (Type 1)
GenderFemale
Credentials CASAC-T
Sole proprietorYes
NPI enumeratedOctober 24, 2017
Last updated in NPPESOctober 24, 2017

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