Provider Demographics
NPI:1366450926
Name:CLEMONS, SYLVIA LINDA (LPC, LCDC)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:LINDA
Last Name:CLEMONS
Suffix:
Gender:F
Credentials:LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 BRIARDALE ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-1326
Mailing Address - Country:US
Mailing Address - Phone:210-590-9800
Mailing Address - Fax:210-590-9166
Practice Address - Street 1:10615 PERRIN BEITEL RD
Practice Address - Street 2:SUITE 304
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-3138
Practice Address - Country:US
Practice Address - Phone:210-590-9800
Practice Address - Fax:210-590-9166
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX01850101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional