MEDICARE: MRS. SYDNIE LEEANN FORDHAM 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	LBA001803	GA

General Provider Information

NPI Number	:	1922720846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SYDNIE LEEANN FORDHAM BCBA

Provider Business Mailing Address
First Line	:	98 BROGDON RD.
Second Line	:
City	:	GUYTON
State	:	GA
Zip	:	31312
Country	:	US
Telephone Number	:	912-675-5409
Fax Number	:

Provider Business Practice Location Address
First Line	:	105 GRAND CENTRAL BLVD
Second Line	:
City	:	POOLER
State	:	GA
Zip	:	31322-4148
Country	:	US
Telephone Number	:	912-244-3305
Fax Number	:

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

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	02/02/2026

Similar Medicare Providers

1710047329 — DR. ROBIN G BERDING O.D
Practice Location Address:

105 GRAND CENTRAL BLVD STE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax: 912-450-9201

1336463744 — SALEM COUNSELING AND CONSULTING, LLC
Practice Location Address:

105 GRAND CENTRAL BLVD , SUITE 107
POOLER, GA
31322-4148

Practice Phone: 912-308-8318
Practice Fax: 912-748-3847

1497001382 — DR. LEEWOOD BRAWNER STILL O.D.
Practice Location Address:

105 GRAND CENTRAL BLVD , SUITE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax:

1497098875 — MR. DANIEL LUIS ORSINI SFIDC
Practice Location Address:

105 GRAND CENTRAL BLVD STE 108
POOLER, GA
31322-4148

Practice Phone: 912-748-1515
Practice Fax:

1215375480 — DR. BENJAMIN JOHNSON CRIDER O.D.
Practice Location Address:

105 GRAND CENTRAL BLVD STE 110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax: 912-450-9201

1760883904 — MYEYEDR OPTOMETRY OF GEORGIA, LLC
Practice Location Address:

105 GRAND CENTRAL BLVD , SUITE #110
POOLER, GA
31322-4148

Practice Phone: 912-450-9200
Practice Fax:

Directions to “ MRS. SYDNIE LEEANN FORDHAM BCBA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.