Healthcare Provider Details

I. General information

NPI: 1699673558
Provider Name (Legal Business Name): SYDNEY ALEXA POOLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2026
Last Update Date: 10/29/2026
Certification Date: 10/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 HADDONFIELD RD STE 230
CHERRY HILL NJ
08002-2201
US

IV. Provider business mailing address

4800 N SCOTTSDALE RD STE 2500
SCOTTSDALE AZ
85251-7725
US

V. Phone/Fax

Practice location:
  • Phone: 856-903-4195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number37AC00988100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: