Provider Demographics
NPI:1356446660
Name:HERRING, MICHAEL WAYNE (MSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:WAYNE
Last Name:HERRING
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WAYNE MEMORIAL DRIVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:GOLDSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27534
Mailing Address - Country:US
Mailing Address - Phone:919-739-9500
Mailing Address - Fax:919-739-9510
Practice Address - Street 1:1400 WAYNE MEMORIAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:GOLDSBORO
Practice Address - State:NC
Practice Address - Zip Code:27534-2256
Practice Address - Country:US
Practice Address - Phone:919-739-9500
Practice Address - Fax:919-739-9510
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC659101YA0400X
NCC0036891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)