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SHELDON LYLE HERRING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
100 AUGUSTA ST, GREENVILLE, SC 29601-3504
(864) 455-2600
(864) 455-2621
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 454-0888
(864) 454-1130

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
428
SC
103T00000X
Psychologist
428
SC
103TB0200X
Cognitive & Behavioral Psychologist
428
SC
103TP0814X
Psychoanalysis Psychologist
428
SC
103TR0400X
Rehabilitation Psychologist
428
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
576007863
TAX ID
SC
05
PS0335
SC
Enumeration date
01/18/2007
Last updated
05/09/2014
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