Provider Demographics
NPI:1508952102
Name:BRINSKELLE, SHERRI ANN (MSW, LCSW,LMSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI ANN
Middle Name:
Last Name:BRINSKELLE
Suffix:
Gender:F
Credentials:MSW, LCSW,LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:686 BIG INDIAN LOOP
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9047
Mailing Address - Country:US
Mailing Address - Phone:704-775-0461
Mailing Address - Fax:
Practice Address - Street 1:608 MCCOMBS AVE
Practice Address - Street 2:
Practice Address - City:KANNAPOLIS
Practice Address - State:NC
Practice Address - Zip Code:28083-3605
Practice Address - Country:US
Practice Address - Phone:704-933-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP018338101YM0800X
NY069571-1101YM0800X
PASW125016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016495020001Medicaid
NY02290137Medicaid
NY02290137Medicaid