MEDICARE: SIDNEY CAROLINE LYBRAND BCBA

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	103K00000X	Behavior Analyst	1-13-13357	FL

General Provider Information

NPI Number	:	1689919367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIDNEY CAROLINE LYBRAND BCBA

Provider Business Mailing Address
First Line	:	204 WILSON ST.
Second Line	:
City	:	UNION
State	:	SC
Zip	:	29379
Country	:	US
Telephone Number	:	321-446-6888
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 WILSON ST
Second Line	:
City	:	UNION
State	:	SC
Zip	:	29379-1646
Country	:	US
Telephone Number	:	321-446-6888
Fax Number	:

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

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	08/08/2025

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