Provider Demographics
NPI:1043947823
Name:WASDIN, SYDNEY ALEXANDRIA (LPC)
Entity Type:Individual
Prefix:MS
First Name:SYDNEY
Middle Name:ALEXANDRIA
Last Name:WASDIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42150 CARLEE LN
Mailing Address - Street 2:
Mailing Address - City:BAY MINETTE
Mailing Address - State:AL
Mailing Address - Zip Code:36507-8455
Mailing Address - Country:US
Mailing Address - Phone:251-583-6321
Mailing Address - Fax:
Practice Address - Street 1:8851 RAND AVE STE B
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-9138
Practice Address - Country:US
Practice Address - Phone:251-583-6321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALLPC04694101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALLPC04694OtherLICENSED PROFESSIONAL COUNSELOR