Healthcare Provider Details
I. General information
NPI: 1912262999
Provider Name (Legal Business Name): KYLENE SHARPTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/06/2012
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1115 E TYLER ST
ATHENS TX
75751-2145
US
IV. Provider business mailing address
1222 10TH ST STE 211
WOODWARD OK
73801-3156
US
V. Phone/Fax
- Phone: 903-292-5015
- Fax: 903-292-5021
- Phone: 580-256-9700
- Fax: 580-256-9704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YA0400X |
| Taxonomy | Addiction (Substance Use Disorder) Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: