Provider Demographics
NPI:1457557860
Name:SYLVESTER, LINDA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 HEREFORD ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48224-2124
Mailing Address - Country:US
Mailing Address - Phone:313-516-6279
Mailing Address - Fax:
Practice Address - Street 1:10101 E CANFIELD ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-1501
Practice Address - Country:US
Practice Address - Phone:313-852-9677
Practice Address - Fax:313-852-9676
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010666551041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801066655OtherSTATE LICENSE