Provider Demographics
NPI:1811061096
Name:SHERVA, OPAL WHICHARD (MSW,LCSW)
Entity type:Individual
Prefix:MS
First Name:OPAL
Middle Name:WHICHARD
Last Name:SHERVA
Suffix:
Gender:F
Credentials:MSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 WESTFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKINGHAM
Mailing Address - State:NC
Mailing Address - Zip Code:28379-8801
Mailing Address - Country:US
Mailing Address - Phone:910-895-3879
Mailing Address - Fax:910-997-5290
Practice Address - Street 1:315 S LONG DR
Practice Address - Street 2:C
Practice Address - City:ROCKINGHAM
Practice Address - State:NC
Practice Address - Zip Code:28379-3991
Practice Address - Country:US
Practice Address - Phone:910-997-5477
Practice Address - Fax:910-997-5290
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0010731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6003569Medicaid