Provider Demographics
NPI:1669131637
Name:WILKES-CLEMENT, SHERALD (LCMHC, LPC)
Entity type:Individual
Prefix:
First Name:SHERALD
Middle Name:
Last Name:WILKES-CLEMENT
Suffix:
Gender:F
Credentials:LCMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PULASKI ST
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-6153
Mailing Address - Country:US
Mailing Address - Phone:704-245-5645
Mailing Address - Fax:
Practice Address - Street 1:5820 E W T HARRIS BLVD
Practice Address - Street 2:STE 109 #258
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28215-3541
Practice Address - Country:US
Practice Address - Phone:704-245-5645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-16
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9338101YP2500X
NC16958101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional