Provider Demographics
NPI:1609575364
Name:CHESTER, SYLVIA SUE
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:SUE
Last Name:CHESTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 STATION WAY
Mailing Address - Street 2:
Mailing Address - City:ADAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30103-6343
Mailing Address - Country:US
Mailing Address - Phone:470-334-9222
Mailing Address - Fax:
Practice Address - Street 1:223 STATION WAY
Practice Address - Street 2:
Practice Address - City:ADAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30103-6343
Practice Address - Country:US
Practice Address - Phone:470-334-9222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052774476104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker