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NPI Code Detail

MEDICARE: SHERRECE D COUSAR LCSW

MEDICARE:   SHERRECE D COUSAR  LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerC018142NC

General Provider Information

NPI Number : 1083212120
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERRECE D COUSAR LCSW
Provider Business Mailing Address
First Line : 705 BURTON ST
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27803-1904
Country : US
Telephone Number : 252-419-1674
Fax Number :
Provider Business Practice Location Address
First Line : 3000 HIGHWOODS BLVD STE 310
Second Line :
City : RALEIGH
State : NC
Zip : 27604-1029
Country : US
Telephone Number : 919-675-3568
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2020
Last Update Date : 12/08/2025

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Directions to “ SHERRECE D COUSAR LCSW” Practice Location

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