Healthcare Provider Details

I. General information

NPI: 1518607340
Provider Name (Legal Business Name): SYDNEY SCHOEN MS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 SUMMERHILL RD STE 2A
TEXARKANA TX
75503-1721
US

IV. Provider business mailing address

5201 SUMMERHILL RD APT 1509
TEXARKANA TX
75503-4638
US

V. Phone/Fax

Practice location:
  • Phone: 903-336-3484
  • Fax:
Mailing address:
  • Phone: 903-490-6168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number83906
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: