Healthcare Provider Details

I. General information

NPI: 1215717764
Provider Name (Legal Business Name): SHARON LYNN HOGUE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2023
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 COMMERCE AVE
CULLMAN AL
35055-6150
US

IV. Provider business mailing address

13979 RIPLEY RD
ATHENS AL
35611-7683
US

V. Phone/Fax

Practice location:
  • Phone: 256-739-5955
  • Fax:
Mailing address:
  • Phone: 938-463-5241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1256
License Number StateAL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: