Provider Demographics
NPI:1083592257
Name:VICK, SYDNEY (MA, BCBA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:VICK
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 REDWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-6928
Mailing Address - Country:US
Mailing Address - Phone:615-631-4144
Mailing Address - Fax:
Practice Address - Street 1:1260 CRAIGLEIGH DR
Practice Address - Street 2:
Practice Address - City:NOLENSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37135-2956
Practice Address - Country:US
Practice Address - Phone:629-245-7351
Practice Address - Fax:615-861-3579
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1930103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst