Healthcare Provider Details

I. General information

NPI: 1811637820
Provider Name (Legal Business Name): JAHAIRA SYKES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 03/29/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13350 W COLONIAL DR STE 340
WINTER GARDEN FL
34787-3977
US

IV. Provider business mailing address

2 SYCAMORE CT APT 205
WINTER SPRINGS FL
32708-5771
US

V. Phone/Fax

Practice location:
  • Phone: 954-225-0205
  • Fax:
Mailing address:
  • Phone: 954-225-0205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW18258
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: