Provider Demographics
NPI:1114780905
Name:LANDESS, SYDNEY (TLMHC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:LANDESS
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 NW BOULDER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-1258
Mailing Address - Country:US
Mailing Address - Phone:515-979-7497
Mailing Address - Fax:
Practice Address - Street 1:1200 SW STATE ST # 2C
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2547
Practice Address - Country:US
Practice Address - Phone:515-954-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA118394101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health