Healthcare Provider Details

I. General information

NPI: 1750798963
Provider Name (Legal Business Name): LEANA SYKES M.ED, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2014
Last Update Date: 07/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 NEWTON AVE SUITE 140A
OAKLYN NJ
08107-1446
US

IV. Provider business mailing address

2312 BERWYN CT
VOORHEES NJ
08043-4669
US

V. Phone/Fax

Practice location:
  • Phone: 856-477-3142
  • Fax:
Mailing address:
  • Phone: 609-685-4104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00502200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: