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Provider Information for 1275978157


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Mrs. SHERRY MICHELLE BLAND LCMHC


Sex: Female

NPI: 1275978157
Last Updated: 2022-09-19
Certification Date: 2022-09-19

Details

NameValue
NPI1275978157
Enumeration Date2013-05-06
NPI TypeNPI-1 Individual
Sole ProprietorYES
StatusActive
Mailing Address 122 W. ELWOOD AVE STE 102 #1400
RAEFORD, NC 28376-2800
United States

Phone: 910-248-9880 | Fax:
 
Primary Practice Address 122 W. ELWOOD AVE STE 102 #1400
RAEFORD, NC 28376-2800
United States

Phone: 910-248-9880 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
No 101Y00000X - Counselor NCA9806
No 101Y00000X - Counselor NC9806
No 101YP2500X - Counselor - ProfessionalNC9806
Yes 101YM0800X - Counselor - Mental HealthNC9806