Provider Demographics
NPI:1508363748
Name:SYKES, LARRY
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:SYKES
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 1:11643 TIMBER RIDGE LN APT 1
Mailing Address - Street 2:
Mailing Address - City:SHARONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2313
Mailing Address - Country:US
Mailing Address - Phone:513-702-4653
Mailing Address - Fax:
Practice Address - Street 1:11643 TIMBER RIDGE LN APT 1
Practice Address - Street 2:
Practice Address - City:SHARONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45241-2313
Practice Address - Country:US
Practice Address - Phone:513-702-4653
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)