Provider Demographics
NPI:1770827784
Name:THOMAS, SHERILL S
Entity Type:Individual
Prefix:
First Name:SHERILL
Middle Name:S
Last Name:THOMAS
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 1:8001 UNIVERSITY RIDGE DR
Mailing Address - Street 2:APT 204
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4117
Mailing Address - Country:US
Mailing Address - Phone:704-909-0947
Mailing Address - Fax:
Practice Address - Street 1:8001 UNIVERSITY RIDGE DR
Practice Address - Street 2:APT 204
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4117
Practice Address - Country:US
Practice Address - Phone:704-909-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0076841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical