Healthcare Provider Details

I. General information

NPI: 1467994343
Provider Name (Legal Business Name): MS. SHERREL AIKEN BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2016
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8202 PLEASANT RIDGE DR
NORTH CHARLESTON SC
29420
US

IV. Provider business mailing address

8202 PLEASANT RIDGE DRIVE
NORTH CHARLESTON SC
29420
US

V. Phone/Fax

Practice location:
  • Phone: 843-737-2647
  • Fax: 843-747-6673
Mailing address:
  • Phone: 843-737-2647
  • Fax: 843-747-6673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: