Healthcare Provider Details

I. General information

NPI: 1003228222
Provider Name (Legal Business Name): CYMBRE LIN PATRICK LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CYMBRE LIN ROOT LCSW

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 HOLLY GROVE RD
CORBIN KY
40701-4427
US

IV. Provider business mailing address

244 HOLLY GROVE RD
CORBIN KY
40701-4427
US

V. Phone/Fax

Practice location:
  • Phone: 606-620-4404
  • Fax: 606-620-4410
Mailing address:
  • Phone: 606-620-4404
  • Fax: 606-620-4410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number253141
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: