Healthcare Provider Details

I. General information

NPI: 1124475025
Provider Name (Legal Business Name): SYKES EARLY INTERVENTION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2016
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 MACON ST
MCDONOUGH GA
30253-3531
US

IV. Provider business mailing address

167 GLEN EAGLE WAY
MCDONOUGH GA
30253-4231
US

V. Phone/Fax

Practice location:
  • Phone: 404-422-9190
  • Fax: 866-704-2179
Mailing address:
  • Phone: 407-247-2631
  • Fax: 866-704-2179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: DIANNA NOBLES SYKES
Title or Position: CEO
Credential: BCBA
Phone: 404-422-9190