Healthcare Provider Details

I. General information

NPI: 1104101930
Provider Name (Legal Business Name): LAMAR SYKES LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 N RITTER AVE
INDIANAPOLIS IN
46219-3026
US

IV. Provider business mailing address

6626 E 75TH STREET
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-359-5467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number35001976A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: