Provider Demographics
NPI:1396555355
Name:KOVACS, SYDNEY NICOLE
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:NICOLE
Last Name:KOVACS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 POINTE CT APT D
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6185
Mailing Address - Country:US
Mailing Address - Phone:850-544-4153
Mailing Address - Fax:
Practice Address - Street 1:736 POINTE CT APT D
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-6185
Practice Address - Country:US
Practice Address - Phone:850-544-4153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-399408106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician