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General NPI Number Information
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NPI Number | 1700267622
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Entity Type | Organization
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Legal Business Name | NSC BEHAVIORAL CONCEPTS, LLC
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Dates
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Enumeration Date | 06/16/2015
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Last Update Date | 02/12/2019
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Provider Practice Location Address
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Address Line | 507 W INNES ST STE 105
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City | SALISBURY
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State | NC
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Zip | 28144-4267
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Country | US
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Telephone | 704-603-6156
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Fax | 704-754-8350
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Provider Business Mailing Address
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Address Line | 507 W INNES ST STE 105
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City | SALISBURY
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State | NC
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Zip | 28144-4267
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Country | US
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Telephone | 704-603-6156
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Fax | 704-754-8350
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE SHERRILL-CORRY
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Credential | PHD
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Telephone | 704-603-6156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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