Provider Demographics
NPI:1629323373
Name:SYKES, JESSICA MARIE (CSAC, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:MARIE
Last Name:SYKES
Suffix:
Gender:F
Credentials:CSAC, LPC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCAS
Mailing Address - Street 1:10436 ORBY CANTRELL HWY
Mailing Address - Street 2:
Mailing Address - City:POUND
Mailing Address - State:VA
Mailing Address - Zip Code:24279-3324
Mailing Address - Country:US
Mailing Address - Phone:276-395-4144
Mailing Address - Fax:
Practice Address - Street 1:10436 ORBY CANTRELL HWY
Practice Address - Street 2:
Practice Address - City:POUND
Practice Address - State:VA
Practice Address - Zip Code:24279-3324
Practice Address - Country:US
Practice Address - Phone:276-395-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0710103450101YA0400X
VA1629323373101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)