Provider Demographics
NPI:1336499235
Name:FELKER, SYDNEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:FELKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SYDNEY
Other - Middle Name:
Other - Last Name:FELKER-ROSS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1150 S MILLEDGE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-6723
Mailing Address - Country:US
Mailing Address - Phone:706-254-7194
Mailing Address - Fax:706-254-7194
Practice Address - Street 1:1150 S MILLEDGE AVE STE 3
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-6723
Practice Address - Country:US
Practice Address - Phone:706-254-7194
Practice Address - Fax:706-955-6858
Is Sole Proprietor?:No
Enumeration Date:2012-09-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA003611103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I645271Medicare PIN