Healthcare Provider Details

I. General information

NPI: 1710151857
Provider Name (Legal Business Name): AMY MICHELLE SYKES LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2008
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2453 MARYLAND AVE
BALTIMORE MD
21218-5018
US

IV. Provider business mailing address

2453 MARYLAND AVE
BALTIMORE MD
21218-5018
US

V. Phone/Fax

Practice location:
  • Phone: 410-889-0011
  • Fax: 410-889-0046
Mailing address:
  • Phone: 410-889-0011
  • Fax: 410-889-0046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC2437
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: