Healthcare Provider Details

I. General information

NPI: 1386240976
Provider Name (Legal Business Name): SHELLBY SYKES MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHELLBY M. SYKES MS

II. Dates (important events)

Enumeration Date: 12/08/2020
Last Update Date: 12/08/2020
Certification Date: 12/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5915 NUEVO LEON ST UNIT 6
NORTH LAS VEGAS NV
89031-4108
US

IV. Provider business mailing address

5915 NUEVO LEON ST UNIT 6
NORTH LAS VEGAS NV
89031-4108
US

V. Phone/Fax

Practice location:
  • Phone: 702-336-6383
  • Fax:
Mailing address:
  • Phone: 702-336-6383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: