Healthcare Provider Details

I. General information

NPI: 1871899609
Provider Name (Legal Business Name): SYDNEY L ISLE LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2011
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1872 N 40 E
OREM UT
84057-2235
US

IV. Provider business mailing address

1872 N 40 E
OREM UT
84057-2235
US

V. Phone/Fax

Practice location:
  • Phone: 385-323-0737
  • Fax: 801-852-0727
Mailing address:
  • Phone: 385-323-0737
  • Fax: 801-852-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3069025-6004
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: