Healthcare Provider Details

I. General information

NPI: 1023972072
Provider Name (Legal Business Name): SYDNEY DILICK SYDNEY DILICK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 JACKSON ST
FREDERICKSBURG VA
22401-5719
US

IV. Provider business mailing address

2504 MANOR DR APT 1H
FREDERICKSBURG VA
22401-7951
US

V. Phone/Fax

Practice location:
  • Phone: 540-373-3223
  • Fax:
Mailing address:
  • Phone: 570-316-1389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0704017483
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: