Provider Demographics
NPI:1871655563
Name:SIKKEMA-SYKES, BRENDA SUZANNE (MS, LPC)
Entity Type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:SUZANNE
Last Name:SIKKEMA-SYKES
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 SANDY MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE BEACH
Mailing Address - State:TX
Mailing Address - Zip Code:78643-9257
Mailing Address - Country:US
Mailing Address - Phone:325-956-9650
Mailing Address - Fax:325-388-5283
Practice Address - Street 1:704 B 5TH STREET
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654
Practice Address - Country:US
Practice Address - Phone:325-956-9650
Practice Address - Fax:325-388-5283
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13722101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028553801Medicaid
TX10072026OtherAMERIGROUP
TX7352LCOtherBCBS