Healthcare Provider Details

I. General information

NPI: 1588100440
Provider Name (Legal Business Name): SHARON HOPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2017
Last Update Date: 01/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 2ND ST SUITE 308
HENDERSON KY
42420-3172
US

IV. Provider business mailing address

269 WOOTEN LN
ISLAND KY
42350-9754
US

V. Phone/Fax

Practice location:
  • Phone: 270-826-8761
  • Fax: 270-826-8737
Mailing address:
  • Phone: 270-499-2068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number171713
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: