Provider Demographics
NPI:1114765633
Name:KEITH, SYDNEY LAMETTA (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:SYDNEY
Middle Name:LAMETTA
Last Name:KEITH
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:LAMETTA
Other - Last Name:BRESEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6416 REA RD STE B7
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-4346
Mailing Address - Country:US
Mailing Address - Phone:704-282-1661
Mailing Address - Fax:
Practice Address - Street 1:6416 REA RD STE B7
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-4346
Practice Address - Country:US
Practice Address - Phone:704-282-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2025-07-25
Deactivation Date:2025-06-10
Deactivation Code:
Reactivation Date:2025-07-24
Provider Licenses
StateLicense IDTaxonomies
NCP0221571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical