Provider Demographics
NPI:1588439632
Name:SKERLAK, SIDNEY (LCSW-A)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:
Last Name:SKERLAK
Suffix:
Gender:F
Credentials:LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7905 VILLAGE CTR N
Mailing Address - Street 2:
Mailing Address - City:SHERRILLS FORD
Mailing Address - State:NC
Mailing Address - Zip Code:28673-9414
Mailing Address - Country:US
Mailing Address - Phone:704-907-0207
Mailing Address - Fax:
Practice Address - Street 1:7905 VILLAGE CTR N
Practice Address - Street 2:
Practice Address - City:SHERRILLS FORD
Practice Address - State:NC
Practice Address - Zip Code:28673-9414
Practice Address - Country:US
Practice Address - Phone:704-907-0207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0194151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical