MEDICARE: SYDNEY SMITH

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	104100000X	Social Worker	6181	SD

General Provider Information

NPI Number	:	1760049001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYDNEY SMITH

Provider Business Mailing Address
First Line	:	1221 PIERCE ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1418
Country	:	US
Telephone Number	:	712-255-0204
Fax Number	:

Provider Business Practice Location Address
First Line	:	204 E MAIN ST
Second Line	:
City	:	ELK POINT
State	:	SD
Zip	:	57025-2334
Country	:	US
Telephone Number	:	605-356-3317
Fax Number	:	866-423-6811

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

Provider Enumeration Date	:	05/22/2019
Last Update Date	:	08/29/2022

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Directions to “ SYDNEY SMITH ” Practice Location

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