Provider Demographics
NPI:1265171128
Name:GIBBS-DUNCAN, ALICIA G (CDCA)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:G
Last Name:GIBBS-DUNCAN
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 PAYNE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-2443
Mailing Address - Country:US
Mailing Address - Phone:216-231-7700
Mailing Address - Fax:
Practice Address - Street 1:13301 MILES AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-5521
Practice Address - Country:US
Practice Address - Phone:216-751-3100
Practice Address - Fax:216-751-2480
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.185709101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)