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Organization

WHITESIDE AND DANIEL, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHERYLL ANNE DANIEL PH.D. (PRESIDENT)
(919) 783-8847
Entity
Organization

Contact information

Practice address
4301 LAKE BOONE TRL, SUITE 208, RALEIGH, NC 27607-7507
(919) 783-8847
(919) 783-0790
Mailing address
4301 LAKE BOONE TRL, SUITE 208, RALEIGH, NC 27607-7507
(919) 783-8847
(919) 783-0790

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
1507
NC
103TB0200X
Cognitive & Behavioral Psychologist
1453
NC
103TC0700X
Clinical Psychologist
1453
NC
103TC2200X
Clinical Child & Adolescent Psychologist
1507
NC
103TE1100X
Exercise & Sports Psychologist
1453
NC
103TF0000X
Family Psychologist
1453
NC
103TF0000X
Family Psychologist
Primary
1507
NC
103TH0100X
Health Service Psychologist
1453
NC
103TS0200X
School Psychologist
1507
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0315K
BLUE CROSS BLUE SHIELD NC
NC
01
0489C
BLUE CROSS BLUE SHIELD NC
NC
Enumeration date
05/03/2007
Last updated
09/11/2025
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