Provider Demographics
NPI:1932296613
Name:MCSHERRY, WILLIAM CLINTON (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLINTON
Last Name:MCSHERRY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 FULTON ST
Mailing Address - Street 2:AMBULATORY CARE SERVICE - 11C
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-3875
Mailing Address - Country:US
Mailing Address - Phone:919-286-0411
Mailing Address - Fax:919-416-8045
Practice Address - Street 1:508 FULTON ST
Practice Address - Street 2:AMBULATORY CARE SERVICE - 11C
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3875
Practice Address - Country:US
Practice Address - Phone:919-286-0411
Practice Address - Fax:919-416-8045
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03265103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service