Provider Demographics
NPI:1366234718
Name:SILER, KORI S
Entity type:Individual
Prefix:
First Name:KORI
Middle Name:S
Last Name:SILER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 GRAMERCY PARK DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27406-8562
Mailing Address - Country:US
Mailing Address - Phone:336-740-5895
Mailing Address - Fax:
Practice Address - Street 1:315 SPRING GARDEN ST
Practice Address - Street 2:UINT 1-D
Practice Address - City:GREENSBOROO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-740-5895
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1992591465Medicaid