Provider Demographics
NPI:1093936239
Name:DANIEL, SHERYLL ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:SHERYLL
Middle Name:ANNE
Last Name:DANIEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CRESCENT GRN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-8118
Mailing Address - Country:US
Mailing Address - Phone:919-233-4131
Mailing Address - Fax:919-233-4168
Practice Address - Street 1:1400 CRESCENT GRN
Practice Address - Street 2:SUITE 120
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-8118
Practice Address - Country:US
Practice Address - Phone:919-233-4131
Practice Address - Fax:919-233-4168
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1453103TB0200X, 103TC0700X, 103TE1100X, 103TF0000X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0315KOtherBLUE CROSS BLUE SHIELD NC
NC0315KOtherBLUE CROSS BLUE SHIELD NC