Provider Demographics
NPI:1255935268
Name:VANAGER, SIBYL (PHD)
Entity type:Individual
Prefix:DR
First Name:SIBYL
Middle Name:
Last Name:VANAGER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SHANNON OAKS CT APT 2H
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29301-5261
Mailing Address - Country:US
Mailing Address - Phone:516-617-5352
Mailing Address - Fax:
Practice Address - Street 1:121 W COUNCIL ST STE 101
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4357
Practice Address - Country:US
Practice Address - Phone:704-603-6156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5679103TC1900X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling