Provider Demographics
NPI:1003228222
Name:ROOT, CYMBRE LIN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:CYMBRE
Middle Name:LIN
Last Name:ROOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 N LIMESTONE # 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-1027
Mailing Address - Country:US
Mailing Address - Phone:859-303-8041
Mailing Address - Fax:
Practice Address - Street 1:230 N LIMESTONE # 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1027
Practice Address - Country:US
Practice Address - Phone:859-303-8041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2531411041C0700X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health