Provider Demographics
NPI:1992881312
Name:ROAN, SYLVIA S (LCSW, LISW-CP,)
Entity type:Individual
Prefix:MRS
First Name:SYLVIA
Middle Name:S
Last Name:ROAN
Suffix:
Gender:F
Credentials:LCSW, LISW-CP,
Other - Prefix:MISS
Other - First Name:SIU-FENG
Other - Middle Name:SYLVIA
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1362 SECRET PATH DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-6545
Mailing Address - Country:US
Mailing Address - Phone:704-236-9390
Mailing Address - Fax:803-693-0701
Practice Address - Street 1:2012 HIGHWAY 160 W
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-8401
Practice Address - Country:US
Practice Address - Phone:704-236-9390
Practice Address - Fax:803-693-0701
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW52371041C0700X
SC95851041C0700X
NCC0068901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical