Provider Demographics
NPI:1083335830
Name:BALL, SYDNEE (LMSW)
Entity type:Individual
Prefix:
First Name:SYDNEE
Middle Name:
Last Name:BALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 INTERSTATE PKWY
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1013
Mailing Address - Country:US
Mailing Address - Phone:716-375-7500
Mailing Address - Fax:
Practice Address - Street 1:159 INTERSTATE PKWY
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1013
Practice Address - Country:US
Practice Address - Phone:716-375-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142001104100000X
104100000X
NY119416104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker