Individual
STEPHANIE RENEE GWINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
523 OAK RIDGE CHURCH RD, CORBIN, KY 40701-5238
(606) 215-3008
Mailing address
610 SMITH LN, LONDON, KY 40741-2822
(606) 215-3008
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
281764
KY
101YM0800X
Mental Health Counselor
281674
KY
101YP2500X
Professional Counselor
281674
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100865430
—
KY
Enumeration date
02/04/2019
Last updated
09/12/2025
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