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NPI Code Detail

MEDICARE: SYDNEY M SINES COUNSELOR TRAINEE

MEDICARE: SYDNEY M SINES COUNSELOR TRAINEE
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
1101YM0800XMental Health CounselorC.2406318-TRNEOH
2101Y00000XCounselorC.2607785OH

General Provider Information

NPI Number : 1780400192
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY M SINES COUNSELOR TRAINEE
Provider Business Mailing Address
First Line : 3095 KETTERING BLVD
Second Line :
City : MORAINE
State : OH
Zip : 45439-1983
Country : US
Telephone Number : 937-293-8300
Fax Number :
Provider Business Practice Location Address
First Line : 3095 KETTERING BLVD
Second Line :
City : MORAINE
State : OH
Zip : 45439-1983
Country : US
Telephone Number : 937-293-8300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2024
Last Update Date : 01/12/2026

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Directions to “ SYDNEY M SINES COUNSELOR TRAINEE” Practice Location

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