Healthcare Provider Details

I. General information

NPI: 1417862079
Provider Name (Legal Business Name): SHEILA ANN BRYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2311 W CONE BLVD STE 223
GREENSBORO NC
27408-4067
US

IV. Provider business mailing address

408 WOODLAKE DR
GREENSBORO NC
27406-5929
US

V. Phone/Fax

Practice location:
  • Phone: 336-542-2884
  • Fax: 336-542-2885
Mailing address:
  • Phone: 336-340-5950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA22843
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: