Provider Demographics
NPI:1386210961
Name:KIGER, SYDNEY GRACE SHELTON (MA, LCMHCA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:GRACE SHELTON
Last Name:KIGER
Suffix:
Gender:F
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:GRACE
Other - Last Name:SHELTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 KISER RD
Mailing Address - Street 2:
Mailing Address - City:KING
Mailing Address - State:NC
Mailing Address - Zip Code:27021-8775
Mailing Address - Country:US
Mailing Address - Phone:336-546-2075
Mailing Address - Fax:
Practice Address - Street 1:105 KISER RD
Practice Address - Street 2:
Practice Address - City:KING
Practice Address - State:NC
Practice Address - Zip Code:27021-8775
Practice Address - Country:US
Practice Address - Phone:336-546-2075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106S00000X
NCA19675101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician