Provider Demographics
NPI:1093277550
Name:NSC BEHAVIORAL CONCEPTS
Entity Type:Organization
Organization Name:NSC BEHAVIORAL CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRILL-CORRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:754-300-3503
Mailing Address - Street 1:1801 NE 123RD ST STE 314
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2883
Mailing Address - Country:US
Mailing Address - Phone:754-300-3503
Mailing Address - Fax:
Practice Address - Street 1:1801 NE 123RD ST STE 314
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2883
Practice Address - Country:US
Practice Address - Phone:754-300-3503
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No175T00000XOther Service ProvidersPeer SpecialistGroup - Multi-Specialty