Provider Demographics
NPI:1700267622
Name:NSC BEHAVIORAL CONCEPTS, LLC
Entity Type:Organization
Organization Name:NSC BEHAVIORAL CONCEPTS, LLC
Other - Org Name:DR. NICOLE SHERRILL-CORRY, PH.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRILL-CORRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-603-6156
Mailing Address - Street 1:507 W INNES ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-4267
Mailing Address - Country:US
Mailing Address - Phone:704-603-6156
Mailing Address - Fax:704-754-8350
Practice Address - Street 1:507 W INNES ST STE 105
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4267
Practice Address - Country:US
Practice Address - Phone:704-603-6156
Practice Address - Fax:704-754-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-16
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty