Provider Demographics
NPI:1538033998
Name:SMITH, SHERRIDA YEVONNE
Entity type:Individual
Prefix:
First Name:SHERRIDA
Middle Name:YEVONNE
Last Name:SMITH
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 1:9866 OAKLAWN BLVD NW
Mailing Address - Street 2:
Mailing Address - City:HUNTERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28078-0177
Mailing Address - Country:US
Mailing Address - Phone:704-269-8534
Mailing Address - Fax:
Practice Address - Street 1:9866 OAKLAWN BLVD NW
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-0177
Practice Address - Country:US
Practice Address - Phone:704-269-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0188661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical