Provider Demographics
NPI:1033237169
Name:SMALLS, SHERELL DENISE (MSW)
Entity Type:Individual
Prefix:
First Name:SHERELL
Middle Name:DENISE
Last Name:SMALLS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12817-304 ATKINS CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277
Mailing Address - Country:US
Mailing Address - Phone:704-540-9640
Mailing Address - Fax:
Practice Address - Street 1:845 N CHURCH ST
Practice Address - Street 2:SUITE 305
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28205
Practice Address - Country:US
Practice Address - Phone:704-262-1336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health