Healthcare Provider Details

I. General information

NPI: 1114651577
Provider Name (Legal Business Name): SHERYL LYNN RETO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11005 LEGENDS LN
MATTHEWS NC
28105-1261
US

IV. Provider business mailing address

11005 LEGENDS LN
MATTHEWS NC
28105-1261
US

V. Phone/Fax

Practice location:
  • Phone: 704-819-8808
  • Fax:
Mailing address:
  • Phone: 704-819-8808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberPO17773
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: