Provider Demographics
NPI:1326596214
Name:BOONE, SHERRY (MS, MSW, LCSWA)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:
Last Name:BOONE
Suffix:
Gender:F
Credentials:MS, MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:622 NC HIGHWAY 32 N
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:NC
Mailing Address - Zip Code:27979-9417
Mailing Address - Country:US
Mailing Address - Phone:252-619-5254
Mailing Address - Fax:
Practice Address - Street 1:920 WOODRIDGE PARK RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-0056
Practice Address - Country:US
Practice Address - Phone:252-619-5254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-20
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0095511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical