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MR. JEREMIAH GIBSON
NPI 1669784203
Marriage & Family Therapist in Brockton, MA

Active since July 12, 2010Opted out of Medicare · through Oct 4, 2026
1115 W CHESTNUT ST, BROCKTON, MA 02301(508) 580-4691 Get Directions Write a Review

NPPES record last updated: July 12, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Jeremiah Gibson NPPES

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

MR. JEREMIAH GIBSON (NPI 1669784203) is an individual marriage & family therapist in Brockton, Massachusetts, licensed in Texas (201445) and active in the NPI registry since July 2010. He has opted out of Medicare through October 4, 2026.

NPPES Registry Identity

NPI1669784203
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameMR. JEREMIAH GIBSON
Location Address1115 W CHESTNUT STBrockton, MA 02301-7501
Mailing Address1115 W Chestnut StBrockton, MA 02301-7501
Phone(508) 580-4691
Sole ProprietorNo
Enumeration DateJuly 12, 2010
✔ NPI 1669784203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in TX · 201445
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
1115 W CHESTNUT ST, Brockton, MA 02301
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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

Mr. Jeremiah Gibson 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 4, 2024 through October 4, 2026.

Opt-Out Effective DateOctober 4, 2024
Opt-Out In Effect ThroughOctober 4, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

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

KATHERINE SHAO
Physical Therapist
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
KATELIN ANN SWAN
Student in an Organized Health Care Education/Training Program
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
JENNA M MONACO
Social Worker (Clinical)
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
MS. JILLIAN MARIE HAYDEN BA PSYCHOLOGY
Counselor (Mental Health)
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
MS. CAITLIN C EDELMAN M.A.
Counselor (Mental Health)
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
AMANDA EICK
Counselor (Mental Health)
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
REBECCA CLEGG
Counselor (Mental Health)
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 580-4691
COURTNEY MAULEN
Occupational Therapist
1115 W CHESTNUT ST
BROCKTON, MA 02301
Plymouth County (508) 559-0473

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 Jeremiah Gibson's NPI number?

The NPI number for Jeremiah Gibson is 1669784203. It was assigned to this individual provider in the NPPES registry on July 12, 2010.

Where is Jeremiah Gibson located?

Jeremiah Gibson practices at 1115 W Chestnut St, Brockton, MA 02301. The listed phone number is (508) 580-4691.

What is Jeremiah Gibson's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Jeremiah Gibson enrolled in Medicare?

No. Jeremiah Gibson has opted out of Medicare through October 4, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jeremiah Gibson was last updated on July 12, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.