Healthcare Provider Details

I. General information

NPI: 1861326910
Provider Name (Legal Business Name): SHERIDAN MERIWETHER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

949 N MALLORY ST APT 2A
HAMPTON VA
23663-1439
US

IV. Provider business mailing address

949 N MALLORY ST APT 2A
HAMPTON VA
23663-1439
US

V. Phone/Fax

Practice location:
  • Phone: 757-695-8610
  • Fax:
Mailing address:
  • Phone: 757-695-8610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.031645
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: