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Individual

CHERYL K. GIBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA, LCADC

Contact information

Practice address
375 TOWN BRANCH RD STE 2, MANCHESTER, KY 40962-1326
(606) 598-0070
(844) 273-1765
Mailing address
86 HIGHWAY 638 STE 1, MANCHESTER, KY 40962-7289
(606) 598-0070
(844) 273-1765

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
248391
KY
101YM0800X
Mental Health Counselor
242173
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7100646500
KY
Enumeration date
07/05/2018
Last updated
01/21/2023
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