Provider Demographics
NPI:1235021569
Name:SYCAMORE VALLEY EMOTIONAL WELLNESS, LLC
Entity type:Organization
Organization Name:SYCAMORE VALLEY EMOTIONAL WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:614-424-0524
Mailing Address - Street 1:5230 MOLLIES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:ADAMSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43802-9794
Mailing Address - Country:US
Mailing Address - Phone:614-424-0524
Mailing Address - Fax:
Practice Address - Street 1:5230 MOLLIES ROCK RD
Practice Address - Street 2:
Practice Address - City:ADAMSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43802-9794
Practice Address - Country:US
Practice Address - Phone:614-424-0524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1285127852Medicaid