Provider Demographics
NPI:1467063453
Name:MCPHEA, SYLICIA EVETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:SYLICIA
Middle Name:EVETTE
Last Name:MCPHEA
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 1:1966 W FARIA LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-7271
Mailing Address - Country:US
Mailing Address - Phone:623-332-4230
Mailing Address - Fax:
Practice Address - Street 1:2545 W QUAIL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-2418
Practice Address - Country:US
Practice Address - Phone:623-332-4230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-18483261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)