MEDICARE: DR. SHERYL RUNAY CANTEY PSY.D.

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	103TC0700X	Clinical Psychologist	801	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	285011	OTHER	SC	MHN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	P00199753	OTHER	SC	METRAHEALTH
4	PVPB166959	OTHER	SC	APS

General Provider Information

NPI Number	:	1467435818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHERYL RUNAY CANTEY PSY.D.

Provider Business Mailing Address
First Line	:	16927 ASHTON OAKS DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-8432
Country	:	US
Telephone Number	:	803-420-2788
Fax Number	:

Provider Business Practice Location Address
First Line	:	16927 ASHTON OAKS DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28278-8432
Country	:	US
Telephone Number	:	803-420-2788
Fax Number	:

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

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	01/25/2012

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