Provider Demographics
NPI:1770455826
Name:GARRIS, SHERITA
Entity type:Individual
Prefix:
First Name:SHERITA
Middle Name:
Last Name:GARRIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 RIVER HAVEN AVE SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-6816
Mailing Address - Country:US
Mailing Address - Phone:336-972-4741
Mailing Address - Fax:
Practice Address - Street 1:250 EXECUTIVE PARK BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1586
Practice Address - Country:US
Practice Address - Phone:984-238-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker