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General NPI Number Information
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NPI Number | 1649611070
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Entity Type | Individual
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Provider Name | CHERYLL ANNETTE SHEPPARD LPCA
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 800 ST. MARY'S ST SUITE 102
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City | RALEIGH
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State | NC
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Zip | 27605-1457
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Country | US
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Telephone | 919-608-0441
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Fax |
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Provider Business Mailing Address
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Address Line | 800 ST. MARY'S STREET, SUITE 102
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City | RALEIGH
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State | NC
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Zip | 27605-1457
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Country | US
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Telephone | 919-608-0441
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Fax | 919-578-3727
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | A10275
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License Number State | NC
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