Provider Demographics
NPI:1316347305
Name:SYLVESTER, CORWYNN (LPC)
Entity type:Individual
Prefix:
First Name:CORWYNN
Middle Name:
Last Name:SYLVESTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 LEEDS WAY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3648
Mailing Address - Country:US
Mailing Address - Phone:770-534-9100
Mailing Address - Fax:770-534-9104
Practice Address - Street 1:629 DAWSONVILLE HWY
Practice Address - Street 2:SUITE 2201
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-2610
Practice Address - Country:US
Practice Address - Phone:770-534-9100
Practice Address - Fax:770-534-9104
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007814101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional