=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669305850
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SYDNEY A JOINER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/05/2026
-----------------------------------------------------
Last Update Date | 06/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1221 INNOVATION DR STE 221
-----------------------------------------------------
City | WHITEWATER
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53190-1483
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 262-473-0670
-----------------------------------------------------
Fax | 608-268-9780
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3013 WORTHINGTON AVE
-----------------------------------------------------
City | MADISON
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53714-1635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 608-742-5518
-----------------------------------------------------
Fax | 608-268-9780
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 12921-123
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------