Provider Demographics
NPI:1457763864
Name:SYKES, SHARON (MSW, MED)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:SYKES
Suffix:
Gender:F
Credentials:MSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4034 HIGH RIDGE PARK
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32311-0605
Mailing Address - Country:US
Mailing Address - Phone:904-521-2202
Mailing Address - Fax:
Practice Address - Street 1:4034 HIGH RIDGE PARK
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32311-0605
Practice Address - Country:US
Practice Address - Phone:904-521-2202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW 8611104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker