Healthcare Provider Details

I. General information

NPI: 1760202923
Provider Name (Legal Business Name): CARLA NOELLE SYKES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/14/2024
Last Update Date: 10/14/2024
Certification Date: 10/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 CHARLES ST STE 105
FREDERICKSBURG VA
22401-3378
US

IV. Provider business mailing address

2029 CHESTERFIELD RD
LOCUST GROVE VA
22508-3133
US

V. Phone/Fax

Practice location:
  • Phone: 540-845-6940
  • Fax:
Mailing address:
  • Phone: 202-361-0773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: