Provider Demographics
NPI:1477331858
Name:STINSON, SYDNEY (LISW-CP)
Entity type:Individual
Prefix:MISS
First Name:SYDNEY
Middle Name:
Last Name:STINSON
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 NORTHWOOD ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-1573
Mailing Address - Country:US
Mailing Address - Phone:803-463-6904
Mailing Address - Fax:
Practice Address - Street 1:201 NORTHWOOD ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-1573
Practice Address - Country:US
Practice Address - Phone:803-463-6904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC172181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical