Provider Demographics
NPI:1275948721
Name:GEORGE, SYDNEY (LMSW)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11791 W 112TH ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-2737
Mailing Address - Country:US
Mailing Address - Phone:913-636-2454
Mailing Address - Fax:
Practice Address - Street 1:11791 W 112TH ST
Practice Address - Street 2:SUITE 102
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2737
Practice Address - Country:US
Practice Address - Phone:913-636-2454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS46211041C0700X
KS90491041C0700X
KS095101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical