Provider Demographics
NPI:1821001413
Name:SLYE, SYDNEY E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:E
Last Name:SLYE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13310 PARTRIDGE HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-6526
Mailing Address - Country:US
Mailing Address - Phone:210-494-6340
Mailing Address - Fax:210-494-6340
Practice Address - Street 1:12915 JONES MALTSBERGER RD
Practice Address - Street 2:424
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4282
Practice Address - Country:US
Practice Address - Phone:210-494-6340
Practice Address - Fax:210-494-6043
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21146104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
00401PMedicare ID - Type Unspecified