Healthcare Provider Details

I. General information

NPI: 1306262548
Provider Name (Legal Business Name): NANCY LYNNE SYKES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2027 S 61ST ST STE 121
TEMPLE TX
76504
US

IV. Provider business mailing address

909 S 19TH ST
TEMPLE TX
76504-5422
US

V. Phone/Fax

Practice location:
  • Phone: 254-624-0140
  • Fax:
Mailing address:
  • Phone: 254-624-0140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number67709
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: