Healthcare Provider Details

I. General information

NPI: 1801656293
Provider Name (Legal Business Name): SYDNEY LABONTE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 BLACKSTONE VALLEY PL STE 302
LINCOLN RI
02865-1163
US

IV. Provider business mailing address

25 BLACKSTONE VALLEY PL STE 302
LINCOLN RI
02865-1163
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-5980
  • Fax: 401-475-0729
Mailing address:
  • Phone: 401-475-0653
  • Fax: 401-475-0729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberISW03497
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: