Healthcare Provider Details

I. General information

NPI: 1841069150
Provider Name (Legal Business Name): SYDNEY TAYLOR BOOTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2023
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

265 W MAIN ST STE 103
KENT OH
44240-2461
US

IV. Provider business mailing address

304 E HOPOCAN AVE
BARBERTON OH
44203-3038
US

V. Phone/Fax

Practice location:
  • Phone: 216-839-2273
  • Fax:
Mailing address:
  • Phone: 330-815-2823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2506854-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: