Provider Demographics
NPI:1417448952
Name:FRED, SYDNEY (LPC)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:FRED
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5068 W PLANO PKWY STE 134
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-4440
Mailing Address - Country:US
Mailing Address - Phone:972-985-7565
Mailing Address - Fax:469-930-0417
Practice Address - Street 1:5068 W PLANO PKWY STE 134
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-4440
Practice Address - Country:US
Practice Address - Phone:972-985-7565
Practice Address - Fax:469-930-0417
Is Sole Proprietor?:No
Enumeration Date:2018-05-21
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81503101YA0400X, 101YM0800X
TX63696104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker