Healthcare Provider Details

I. General information

NPI: 1306764170
Provider Name (Legal Business Name): SIDNEE SAWYER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

322 S BUCHANAN ST
EDWARDSVILLE IL
62025-2086
US

IV. Provider business mailing address

1057 LAFAYETTE CT
COLLINSVILLE IL
62234-3753
US

V. Phone/Fax

Practice location:
  • Phone: 618-713-5669
  • Fax:
Mailing address:
  • Phone: 319-795-6679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number180.018259
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: