MEDICARE: MS. LINDA CAROLE SHERRARD LPC, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	LPC010815	GA
2	101YP2500X	Professional Counselor	6677	SC

General Provider Information

NPI Number	:	1104219617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDA CAROLE SHERRARD LPC, NCC

Provider Business Mailing Address
First Line	:	1367 W MARTINTOWN RD STE 7
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860-8920
Country	:	US
Telephone Number	:	803-262-4307
Fax Number	:	803-845-4405

Provider Business Practice Location Address
First Line	:	1367 W MARTINTOWN RD STE 7
Second Line	:
City	:	NORTH AUGUSTA
State	:	SC
Zip	:	29860
Country	:	US
Telephone Number	:	803-262-4307
Fax Number	:	803-845-4405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2015
Last Update Date	:	10/02/2019

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