Provider Demographics
NPI:1073258620
Name:CALL, SYDNEY (MA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:CALL
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4246 W SAW BLADE LN APT 103
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-0030
Mailing Address - Country:US
Mailing Address - Phone:720-855-5846
Mailing Address - Fax:
Practice Address - Street 1:211 E COEUR D ALENE AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4926
Practice Address - Country:US
Practice Address - Phone:877-485-2776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-28
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IDLPC-9616101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor