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General NPI Number Information
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NPI Number | 1114539376
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Entity Type | Individual
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Provider Name | SYDNEY STEVENS LPC
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Gender | Female
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Dates
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Enumeration Date | 08/19/2020
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1022 N 4TH ST STE 101
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City | COEUR D ALENE
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State | ID
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Zip | 83814-3100
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Country | US
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Telephone | 208-449-6491
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Fax | 208-450-2239
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Provider Business Mailing Address
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Address Line | 901 E PENNSYLVANIA AVE
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City | COEUR D ALENE
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State | ID
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Zip | 83814-4336
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Country | US
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Telephone | 208-449-6491
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Fax | 208-450-2239
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC7817
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC7817
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License Number State | ID
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