Provider Demographics
NPI:1649841800
Name:RICE, SIDNEY LAUREN (LCSW)
Entity type:Individual
Prefix:
First Name:SIDNEY
Middle Name:LAUREN
Last Name:RICE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY
Mailing Address - State:NC
Mailing Address - Zip Code:28150-5111
Mailing Address - Country:US
Mailing Address - Phone:704-707-5084
Mailing Address - Fax:
Practice Address - Street 1:5540 CENTERVIEW DR STE 204
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-8012
Practice Address - Country:US
Practice Address - Phone:855-467-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0164911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical