Provider Demographics
NPI:1659674158
Name:ROY, SYLVIA A (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:A
Last Name:ROY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 NORMAN ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-5003
Mailing Address - Country:US
Mailing Address - Phone:413-736-8329
Mailing Address - Fax:413-746-4270
Practice Address - Street 1:149 HIGH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2614
Practice Address - Country:US
Practice Address - Phone:413-774-2304
Practice Address - Fax:413-773-0118
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2032492104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1303295 (MH)Medicaid
MA1307576 (SA)Medicaid
M18463OtherBC / BS
MA1307576 (SA)Medicaid