Provider Demographics
NPI:1770976169
Name:WOMACK, SYLVIA ANNETTE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:ANNETTE
Last Name:WOMACK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:SYLVIA
Other - Middle Name:ANNETTE
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:403 COPPER CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-4014
Mailing Address - Country:US
Mailing Address - Phone:912-429-1077
Mailing Address - Fax:
Practice Address - Street 1:6605 ABERCORN ST STE 213E
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405
Practice Address - Country:US
Practice Address - Phone:912-429-1077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW005413104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker