Healthcare Provider Details

I. General information

NPI: 1609731967
Provider Name (Legal Business Name): SHERRY ANN GLOVER MCCOY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5568 PITTMAN GROVE CHURCH RD
RAEFORD NC
28376-7146
US

IV. Provider business mailing address

5568 PITTMAN GROVE CHURCH RD
RAEFORD NC
28376-7146
US

V. Phone/Fax

Practice location:
  • Phone: 910-624-0068
  • Fax:
Mailing address:
  • Phone: 910-624-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: