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MARK J. GIBSON LCSW
NPI 1215211008
Social Worker - Clinical in Sutter Creek, CA

Active since September 28, 2011Opted out of Medicare · through Oct 1, 2026
18 BRYSON DR, SUTTER CREEK, CA 95685(530) 210-2285(530) 492-0902 Get Directions Write a Review

NPPES record last updated: December 5, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark J. Gibson Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK J. GIBSON LCSW (NPI 1215211008) is an individual clinical provider in Sutter Creek, California, licensed in California (27742) and active in the NPI registry since September 2011. He has opted out of Medicare through October 1, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1215211008
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMARK J. GIBSONCredential: LCSW
Location Address18 BRYSON DRSutter Creek, CA 95685-4118
Mailing Address18 Bryson DrSutter Creek, CA 95685-4118 · (530) 210-2285 · Fax (530) 492-0902
Phone(530) 210-2285
Fax(530) 492-0902
Sole ProprietorYes
Enumeration DateSeptember 28, 2011
Last NPPES UpdateDecember 5, 2023
NPPES CertifiedDecember 5, 2023
✔ NPI 1215211008 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 27742
Definition
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.
18 BRYSON DR, Sutter Creek, CA 95685
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mark J. Gibson Lcsw has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2016 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2016
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95685 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $58.87 – $176.60
Typical copayment $0.00 (range $14.71 – $44.15)
Most-billed visit code NA
Established Patient
$73.16 typical visit price
range $19.28 – $144.60
Typical copayment $18.29 (range $4.82 – $36.15)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. CHELSEA YULE LCSW
Social Worker (Clinical)
18 BRYSON DR
SUTTER CREEK, CA 95685
Amador County (209) 560-0414
MS. MEGAN EMILY HARRIS LCSW
Social Worker (Clinical)
18 BRYSON DR
SUTTER CREEK, CA 95685
Amador County (209) 498-8033

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mark Gibson's NPI number?

The NPI number for Mark Gibson is 1215211008. It was assigned to this individual provider in the NPPES registry on September 28, 2011.

Where is Mark Gibson located?

Mark Gibson practices at 18 Bryson Dr, Sutter Creek, CA 95685. The listed phone number is (530) 210-2285.

What is Mark Gibson's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Mark Gibson enrolled in Medicare?

No. Mark Gibson has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Mark Gibson was last updated on December 5, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.