Basic Information
Provider Information
NPI: 1194061937
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NORMAN
FirstName: SHERRY
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: MA, LCAS, LPC
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 609 CARRINGTON PL
Address2:  
City: ARDEN
State: NC
PostalCode: 287048810
CountryCode: US
TelephoneNumber: 8286993518
FaxNumber:  
Practice Location
Address1: 119 TUNNEL RD STE D
Address2:  
City: ASHEVILLE
State: NC
PostalCode: 288051800
CountryCode: US
TelephoneNumber: 8283501000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/26/2012
LastUpdateDate: 12/26/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X804NCY Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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