Provider Demographics
NPI:1609427491
Name:REINERT, SYDNEY MARIE (BA, MS, LPCA)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:MARIE
Last Name:REINERT
Suffix:
Gender:F
Credentials:BA, MS, LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 BELLE ISLE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8379
Mailing Address - Country:US
Mailing Address - Phone:843-256-3371
Mailing Address - Fax:
Practice Address - Street 1:1501 BELLE ISLE AVE STE 110
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8379
Practice Address - Country:US
Practice Address - Phone:843-256-3371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-24
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2204331101YP2500X
101Y00000X
KYRBT-19-99537103K00000X
SC8212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYRBT-19-99537OtherRBT CERTIFICATE