Provider Demographics
NPI:1730751348
Name:HOLDER, SHERRY KELLEY
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:KELLEY
Last Name:HOLDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NEW COVENANT DR
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-8385
Mailing Address - Country:US
Mailing Address - Phone:828-545-2317
Mailing Address - Fax:
Practice Address - Street 1:39 NEW COVENANT DR
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-8385
Practice Address - Country:US
Practice Address - Phone:828-545-2317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-13
Last Update Date:2025-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0166791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical