Individual
SHALON KALOLE SHERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
500 N MAIN ST STE 4, SUMMERVILLE, SC 29483-6439
(843) 871-4790
Mailing address
500 N MAIN ST STE 4, SUMMERVILLE, SC 29483-6439
(843) 871-4790
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9290
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q489003334
MEDICARE PTAN
SC
Enumeration date
06/19/2006
Last updated
07/21/2022
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