Provider Demographics
NPI:1942263074
Name:SYLVESTER, DEBRA (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SYLVESTER
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 1:2773 FILMORE ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84106-3544
Mailing Address - Country:US
Mailing Address - Phone:801-949-1993
Mailing Address - Fax:801-519-9608
Practice Address - Street 1:1059 E 900 S
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-1400
Practice Address - Country:US
Practice Address - Phone:801-949-1993
Practice Address - Fax:801-519-9608
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT290488-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical