Provider Demographics
NPI:1396248837
Name:MCCARTHY, SYDNEY MICHELE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MICHELE
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 SANTERRE AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-1750
Mailing Address - Country:US
Mailing Address - Phone:254-744-9845
Mailing Address - Fax:
Practice Address - Street 1:1619 SANTERRE AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75211-1750
Practice Address - Country:US
Practice Address - Phone:254-744-9845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109782235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist