Provider Demographics
NPI:1093569816
Name:SYKES, JACQUELYN M (LCSW)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:M
Last Name:SYKES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5934 PREMIER WAY APT 2317
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-7883
Mailing Address - Country:US
Mailing Address - Phone:646-226-1471
Mailing Address - Fax:
Practice Address - Street 1:5934 PREMIER WAY APT 2317
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-7883
Practice Address - Country:US
Practice Address - Phone:646-226-1471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL199991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical