Healthcare Provider Details

I. General information

NPI: 1255252797
Provider Name (Legal Business Name): HALEY SHARP
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: HALEY GOUINE

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 N MAIN ST
MORGANTOWN KY
42261-7919
US

IV. Provider business mailing address

380 SUWANNEE TRAIL ST
BOWLING GREEN KY
42103-7956
US

V. Phone/Fax

Practice location:
  • Phone: 270-526-3877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number305694
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: