Provider Demographics
NPI:1396273140
Name:NSC BEHAVIORAL CONCEPTS, LLC
Entity type:Organization
Organization Name:NSC BEHAVIORAL CONCEPTS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERRILL-CORRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-603-6156
Mailing Address - Street 1:200 W INNES ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144-4327
Mailing Address - Country:US
Mailing Address - Phone:704-603-6156
Mailing Address - Fax:704-754-8350
Practice Address - Street 1:1047 GASTON ST
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3725
Practice Address - Country:US
Practice Address - Phone:704-603-6156
Practice Address - Fax:704-753-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health