=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225928575
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHLOE CORLEY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2025
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 N MAIN ST
-----------------------------------------------------
City | MORGANTOWN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42261-7919
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-526-3877
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 380 SUWANNEE TRAIL ST
-----------------------------------------------------
City | BOWLING GREEN
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 42103-7956
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 270-901-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------