Provider Demographics
NPI:1144801218
Name:STEPHENSON, SYDNEY (MSPC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:MSPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 MAYTIDE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15227-1847
Mailing Address - Country:US
Mailing Address - Phone:724-216-7349
Mailing Address - Fax:
Practice Address - Street 1:2018 S BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-2191
Practice Address - Country:US
Practice Address - Phone:412-214-8961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-19
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC015472101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional