Healthcare Provider Details

I. General information

NPI: 1063352573
Provider Name (Legal Business Name): SYDNEY M HUTSON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 CHATHAM TRACE CIR
CHERAW SC
29520-4038
US

IV. Provider business mailing address

88 CHATHAM TRACE CIR
CHERAW SC
29520-4038
US

V. Phone/Fax

Practice location:
  • Phone: 843-337-3893
  • Fax:
Mailing address:
  • Phone: 843-337-3893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number11269
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: