Provider Demographics
NPI:1649544263
Name:SYLVESTER, EVELYN (LCPS)
Entity type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7024
Mailing Address - Country:US
Mailing Address - Phone:207-782-3386
Mailing Address - Fax:
Practice Address - Street 1:276 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7024
Practice Address - Country:US
Practice Address - Phone:207-782-3386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3586101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health