MEDICARE: SYDNEY M CANFIELD 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	1041C0700X	Clinical Social Worker	108621	TX

General Provider Information

NPI Number	:	1598482341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY M CANFIELD LCSW

Provider Business Mailing Address
First Line	:	PO BOX 99213
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76199-0213
Country	:	US
Telephone Number	:	682-885-1860
Fax Number	:	682-885-1396

Provider Business Practice Location Address
First Line	:	901 7TH AVE STE 4124
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2722
Country	:	US
Telephone Number	:	682-885-7439
Fax Number	:	682-885-1672

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

Provider Enumeration Date	:	10/24/2022
Last Update Date	:	05/07/2026

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