Provider Demographics
NPI:1174192322
Name:SYKES, TYANA SYMONE (LCSWA)
Entity Type:Individual
Prefix:
First Name:TYANA
Middle Name:SYMONE
Last Name:SYKES
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 S WESTGATE DR STE D
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-1632
Mailing Address - Country:US
Mailing Address - Phone:866-700-1606
Mailing Address - Fax:
Practice Address - Street 1:319 S WESTGATE DR STE D
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27407-1632
Practice Address - Country:US
Practice Address - Phone:866-700-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-22
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P0154071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical