Individual
STERLING CANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1400 CLEVELAND ST, GREENVILLE, SC 29607-2410
(864) 467-4757
Mailing address
3106 BETHEL RD UNIT 72, SIMPSONVILLE, SC 29681-5614
(864) 569-2533
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
4128721
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891795738
—
SC
Enumeration date
01/24/2023
Last updated
01/24/2023
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