MEDICARE: SHERIDA YVETTE HINTON LCMHC-A, LCAS-A

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	101YM0800X	Mental Health Counselor		NC

General Provider Information

NPI Number	:	1881868115
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERIDA YVETTE HINTON LCMHC-A, LCAS-A

Provider Business Mailing Address
First Line	:	122 E SAINT JAMES ST
Second Line	:
City	:	TARBORO
State	:	NC
Zip	:	27886-5016
Country	:	US
Telephone Number	:	252-565-3196
Fax Number	:

Provider Business Practice Location Address
First Line	:	509 ELLIS RD
Second Line	:
City	:	TARBORO
State	:	NC
Zip	:	27886-8320
Country	:	US
Telephone Number	:	252-565-3196
Fax Number	:

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

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	11/07/2022

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