Provider Demographics
NPI:1487245213
Name:YANG, SHERRIE
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:
Last Name:YANG
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 1:1725 LAKEDELL DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-2013
Mailing Address - Country:US
Mailing Address - Phone:704-956-3835
Mailing Address - Fax:
Practice Address - Street 1:280 EXECUTIVE PARK DRIVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025
Practice Address - Country:US
Practice Address - Phone:704-237-4240
Practice Address - Fax:888-261-6694
Is Sole Proprietor?:No
Enumeration Date:2021-02-03
Last Update Date:2023-08-01
Deactivation Date:2023-06-01
Deactivation Code:
Reactivation Date:2023-08-01
Provider Licenses
StateLicense IDTaxonomies
NCA18909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health