Provider Demographics
NPI:1346985124
Name:LOCKLEAR-CARTER, SHERRI
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:LOCKLEAR-CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 HARRISON CROSSROAD LOOP
Mailing Address - Street 2:
Mailing Address - City:REIDSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27320-8380
Mailing Address - Country:US
Mailing Address - Phone:336-564-8620
Mailing Address - Fax:
Practice Address - Street 1:260 HARRISON CROSSROAD LOOP
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27320-8380
Practice Address - Country:US
Practice Address - Phone:336-564-8620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-05
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26110101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty