Provider Demographics
NPI:1457794208
Name:GIBBS, SHERRI LYNN (MA)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:LYNN
Last Name:GIBBS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 KELSEY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-7870
Mailing Address - Country:US
Mailing Address - Phone:606-528-1033
Mailing Address - Fax:606-215-3527
Practice Address - Street 1:45 WEST POINT LANE
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-7804
Practice Address - Country:US
Practice Address - Phone:606-523-9723
Practice Address - Fax:606-214-3527
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-11
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1224101YA0400X
KY0215101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)