MEDICARE: MR. ROBERT E SYKES JR. LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	1196	NC
2	106H00000X	Marriage & Family Therapist	1196	NC

General Provider Information

NPI Number	:	1215136494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT E SYKES JR. LMFT

Provider Business Mailing Address
First Line	:	1704 US HIGHWAY 158
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-8378
Country	:	US
Telephone Number	:	252-519-2273
Fax Number	:	252-535-2399

Provider Business Practice Location Address
First Line	:	1704 US HIGHWAY 158
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-8378
Country	:	US
Telephone Number	:	252-519-2273
Fax Number	:	252-535-2399

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/17/2007

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