Provider Demographics
NPI:1902495708
Name:SUTTON, SHERITA GRACE EASTMON (MSW,MPH,LCSW-A, CHES)
Entity Type:Individual
Prefix:MRS
First Name:SHERITA
Middle Name:GRACE EASTMON
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MSW,MPH,LCSW-A, CHES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:683 E PALMER ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-6648
Mailing Address - Country:US
Mailing Address - Phone:910-875-3717
Mailing Address - Fax:910-875-6351
Practice Address - Street 1:7769 ADRIAN DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28314-6311
Practice Address - Country:US
Practice Address - Phone:910-489-3658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30161174H00000X
374J00000X
NCP0148371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174H00000XOther Service ProvidersHealth Educator
No374J00000XNursing Service Related ProvidersDoula