MEDICARE: MRS. SYDNEY DEELEE ZALDIVAR LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	04899	KS

General Provider Information

NPI Number	:	1205651874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SYDNEY DEELEE ZALDIVAR LPC

Provider Business Mailing Address
First Line	:	1109 E 5TH ST
Second Line	:
City	:	DOUGLASS
State	:	KS
Zip	:	67039-9656
Country	:	US
Telephone Number	:	316-648-8361
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 N OSAGE RD
Second Line	:
City	:	DERBY
State	:	KS
Zip	:	67037-2084
Country	:	US
Telephone Number	:	316-788-1907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	02/26/2025

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