MEDICARE: MR. LARRY E SIDNEY MA, LPC, NCC, LCSW

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	000729	MO
2	1041C0700X	Clinical Social Worker	003878	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	127826	OTHER	MO	NEW DIRECTIONS BEHAVIORAL
2	28784029	OTHER	MO	BLUECROSS BLUE SHIELDS

General Provider Information

NPI Number	:	1215995790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LARRY E SIDNEY MA, LPC, NCC, LCSW

Provider Business Mailing Address
First Line	:	9812 WINSLOW PL
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-3269
Country	:	US
Telephone Number	:	816-942-5555
Fax Number	:

Provider Business Practice Location Address
First Line	:	3101 BROADWAY ST
Second Line	:	SUITE 230
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-2659
Country	:	US
Telephone Number	:	816-531-2900
Fax Number	:	816-531-2901

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

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	09/11/2025

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Directions to “ MR. LARRY E SIDNEY MA, LPC, NCC, LCSW” Practice Location

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