Provider Demographics
NPI:1609963420
Name:HITCHCOCK, SHERRI JOHNSON (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHERRI
Middle Name:JOHNSON
Last Name:HITCHCOCK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:SHERRI
Other - Middle Name:RENEE'
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-C
Mailing Address - Street 1:116 SPINEL LN
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7242
Mailing Address - Country:US
Mailing Address - Phone:919-624-6954
Mailing Address - Fax:
Practice Address - Street 1:116 SPINEL LN
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7242
Practice Address - Country:US
Practice Address - Phone:919-624-6954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060251041C0700X
MD119231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD384854OtherMANAGED HEALTH NETWORK
517251OtherUHC MAMSI
MDLM49EAOtherCAREFIRST BCBS GROUP
MD609550002Medicaid
MD894952-01OtherCAREFIRST BCBS PIN
259147000OtherMAGELLAN GROUP
MD522156095OtherAMERICAN PSYCH SYSTEM
R968OtherCAREFIRST FEDERAL GROUP
MD522156095OtherNCPPO
MD522156095OtherUNITED BEHAVIORAL HEALTH
MD0036OtherCAREFIRST BCBS FEDERAL PI
MDLM49EAOtherCAREFIRST BCBS GROUP
MD522156095OtherNCPPO