Provider Demographics
NPI:1679778302
Name:SYKES, KELLY M (PHD)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:M
Last Name:SYKES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 COURT ST
Mailing Address - Street 2:SUITE 705
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4421
Mailing Address - Country:US
Mailing Address - Phone:917-355-2544
Mailing Address - Fax:347-789-3025
Practice Address - Street 1:32 COURT ST
Practice Address - Street 2:SUITE 705
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4421
Practice Address - Country:US
Practice Address - Phone:917-355-2544
Practice Address - Fax:347-789-3025
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017178-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical