Provider Demographics
NPI:1700039930
Name:SYLVESTER, VICKIE Y (LCSW PIP)
Entity Type:Individual
Prefix:MS
First Name:VICKIE
Middle Name:Y
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LCSW PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89306
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57109-9306
Mailing Address - Country:US
Mailing Address - Phone:605-275-2872
Mailing Address - Fax:605-335-5514
Practice Address - Street 1:236 E HOLLY BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:SD
Practice Address - Zip Code:57005-1171
Practice Address - Country:US
Practice Address - Phone:605-582-7356
Practice Address - Fax:605-582-7357
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD17221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical