Provider Demographics
NPI:1497325518
Name:BLEVINS, SYDNEY PAIGE (BA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:PAIGE
Last Name:BLEVINS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:SYDNEY
Other - Middle Name:PAIGE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:171 E 42ND ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41015-1843
Mailing Address - Country:US
Mailing Address - Phone:859-638-5546
Mailing Address - Fax:
Practice Address - Street 1:8140 DREAM ST STE D
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-7532
Practice Address - Country:US
Practice Address - Phone:606-465-4634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker